Y Van Nieuwenhove1, M Aerts, B Neyns, G Delvaux. 1. Department of Surgery, Academisch Ziekenhuis, Vrije Universiteit Brussel, Laarbeeklaan 101, B-1090 Brussels, Belgium. hlkvney@az.vub.ac.be
Abstract
AIMS: For patients with unresectable liver metastases from colorectal cancer (CRC), hepatic artery infusion chemotherapy (HAIC) can produce higher response rates as compared to systemic chemotherapy. However, the added morbidity and early dysfunction after catheter placement have negatively influenced the outcomes of randomized studies. METHODS: Between July 1998 and March 2006, 29 patients with unresectable liver metastases from CRC were included in three different HAIC protocols. A catheter was laparoscopically placed in the gastroduodenal artery, retrograde to the common hepatic artery and was attached to a subcutaneous access port. Perioperative parameters and catheter-associated adverse events during chemotherapy were studied. RESULTS: Mean operating time was 106+/-29 min and median duration of hospitalization was 2 days (range: 1-13). No major perioperative complications occurred but there was 1 death (3.6%) 1 week after surgery due to hemorrhagic shock after necrosis and rupture of the hepatic artery. During a median follow-up of 10 months (range: 0-35) we observed 5 (17%) catheter-associated adverse events, but in only 2 patients (7%) this resulted in a loss of catheter function before the end of chemotherapy. Overall median duration of HAIC was 8 months (range: 1-28). CONCLUSION: Laparoscopic placement of a hepatic artery catheter is associated with a low operative morbidity. The observed functionality of the hepatic artery ports in our series is encouraging for the use in future studies of HAIC.
AIMS: For patients with unresectable liver metastases from colorectal cancer (CRC), hepatic artery infusion chemotherapy (HAIC) can produce higher response rates as compared to systemic chemotherapy. However, the added morbidity and early dysfunction after catheter placement have negatively influenced the outcomes of randomized studies. METHODS: Between July 1998 and March 2006, 29 patients with unresectable liver metastases from CRC were included in three different HAIC protocols. A catheter was laparoscopically placed in the gastroduodenal artery, retrograde to the common hepatic artery and was attached to a subcutaneous access port. Perioperative parameters and catheter-associated adverse events during chemotherapy were studied. RESULTS: Mean operating time was 106+/-29 min and median duration of hospitalization was 2 days (range: 1-13). No major perioperative complications occurred but there was 1 death (3.6%) 1 week after surgery due to hemorrhagic shock after necrosis and rupture of the hepatic artery. During a median follow-up of 10 months (range: 0-35) we observed 5 (17%) catheter-associated adverse events, but in only 2 patients (7%) this resulted in a loss of catheter function before the end of chemotherapy. Overall median duration of HAIC was 8 months (range: 1-28). CONCLUSION: Laparoscopic placement of a hepatic artery catheter is associated with a low operative morbidity. The observed functionality of the hepatic artery ports in our series is encouraging for the use in future studies of HAIC.
Authors: Malgorzata M Bala; Robert P Riemsma; Robert Wolff; Michal Pedziwiatr; Jerzy W Mitus; Dawid Storman; Mateusz J Swierz; Jos Kleijnen Journal: Cochrane Database Syst Rev Date: 2019-07-10
Authors: Yanina J L Jansen; Gontran Verset; Kelly Schats; Pieter-Jan Van Dam; Teofila Seremet; Mark Kockx; Jean-Luc B Van Laethem; Bart Neyns Journal: ESMO Open Date: 2019-03-05
Authors: Christian Heiliger; Jerzy Piecuch; Alexander Frank; Dorian Andrade; Viktor von Ehrlich-Treuenstätt; Dobromira Evtimova; Florian Kühn; Jens Werner; Konrad Karcz Journal: Sci Rep Date: 2021-07-20 Impact factor: 4.379