BACKGROUND: The prognosis of unresectable hepatic colorectal metastases is poor even if chemotherapy is administered. The purpose of this study was to evaluate the long-term efficacy of hepatic arterial infusion (HAI) chemotherapy and hepatectomy following HAI for such condition. METHODS: Seventy-two patients with unresectable hepatic colorectal metastases received continuous HAI of 5-fluorouracil. RESULTS: The overall response rate was 38%. The median survival of all patients was 18 months. The overall 3-year survival rate was 18%. Seven patients (10%) survived more than 58 months. Of the eight patients with a complete response, seven developed liver and/or lung metastases, and of these, one patient undergoing additional hepatectomy has been disease-free and the other six receiving chemotherapy died of disease. Another complete-response case died of liver abscess. Of the 19 patients with a partial response, six could undergo hepatectomy after HAI. The overall 5-year survival rate of seven patients undergoing hepatectomy was 71%, whereas for patients without hepatectomy, the rate was 0%. CONCLUSIONS: Most patients showing response after HAI for unresectable hepatic colorectal metastases had relapses. The long-term prognosis of patients undergoing hepatectomy after HAI was favorable. Therefore, when HAI makes liver metastases resectable, they should be resected.
BACKGROUND: The prognosis of unresectable hepatic colorectal metastases is poor even if chemotherapy is administered. The purpose of this study was to evaluate the long-term efficacy of hepatic arterial infusion (HAI) chemotherapy and hepatectomy following HAI for such condition. METHODS: Seventy-two patients with unresectable hepatic colorectal metastases received continuous HAI of 5-fluorouracil. RESULTS: The overall response rate was 38%. The median survival of all patients was 18 months. The overall 3-year survival rate was 18%. Seven patients (10%) survived more than 58 months. Of the eight patients with a complete response, seven developed liver and/or lung metastases, and of these, one patient undergoing additional hepatectomy has been disease-free and the other six receiving chemotherapy died of disease. Another complete-response case died of liver abscess. Of the 19 patients with a partial response, six could undergo hepatectomy after HAI. The overall 5-year survival rate of seven patients undergoing hepatectomy was 71%, whereas for patients without hepatectomy, the rate was 0%. CONCLUSIONS: Most patients showing response after HAI for unresectable hepatic colorectal metastases had relapses. The long-term prognosis of patients undergoing hepatectomy after HAI was favorable. Therefore, when HAI makes liver metastases resectable, they should be resected.
Authors: David L Bartlett; Jordan Berlin; Gregory Y Lauwers; Wells A Messersmith; Nicholas J Petrelli; Alan P Venook Journal: Ann Surg Oncol Date: 2006-09-06 Impact factor: 5.344
Authors: Chusilp Charnsangavej; Bryan Clary; Yuman Fong; Axel Grothey; Timothy M Pawlik; Michael A Choti Journal: Ann Surg Oncol Date: 2006-09-01 Impact factor: 5.344
Authors: Michael A Choti; James V Sitzmann; Marcelo F Tiburi; Wuthi Sumetchotimetha; Ram Rangsin; Richard D Schulick; Keith D Lillemoe; Charles J Yeo; John L Cameron Journal: Ann Surg Date: 2002-06 Impact factor: 12.969
Authors: D C Hohn; R J Stagg; M A Friedman; J F Hannigan; A Rayner; R J Ignoffo; P Acord; B J Lewis Journal: J Clin Oncol Date: 1989-11 Impact factor: 44.544
Authors: K H Link; J Pillasch; A Formentini; E Sunelaitis; G Leder; F Safi; M Kornmann; H G Beger Journal: Eur J Surg Oncol Date: 1999-08 Impact factor: 4.424