Development of isolated hepatic perfusion for patients who have unresectable hepatic malignancies.

Isolated hepatic perfusion (IHP) has a role in the treatment of colorectal carcinoma, ocular melanoma, and neuroendocrine tumor liver metastases. Outcomes data with IHP have improved with better patient selection, adoption of standard operative techniques, use of appropriate types and doses of chemotherapeutics, and careful measures of efficacy and survival. The percutaneous approach to IHP, the treatment of additional tumor types (eg, unresectable hepatocellular carcinoma, gastrointestinal sarcoma, occult primaries), the use of other agents within the IHP circuit, and gene therapy all deserve additional attention.