Intermittent occlusion of the hepatic artery and infusion chemotherapy for carcinoma of the liver.

Twenty-nine patients with hepatocellular or metastatic colon carcinoma were included in the present study. A system of staging the extent of disease was developed to provide a guideline for patient selection and evaluation of the results of therapy. Sixteen patients received intraarterial infusion chemotherapy only and thirteen were treated by a combination of intermittent occlusion of the hepatic artery and infusion chemotherapy. In this latter group intermittent occlusion of the hepatic artery was employed as an alternative to hepatic artery ligation. Patients in either group having disease confined to the liver experienced good response to treatment, had a low incidence of drug-related complications, and survived for relatively long periods. The study confirmed that intermittent occlusion of the hepatic artery is a safe procedure and that it is not accompanied by an increase in morbidity or mortality. The rationale for using this technic and the advantages it has over hepatic artery ligation were presented. The procedure is currently being utilized with increasing frequency in patients in relatively early stages of the disease. Accumulation of more material and longer periods of follow-up are required to determine the therapeutic advantages of the new method over infusion chemotherapy alone.