Long-term results of hepatectomy after hepatic arterial infusion chemotherapy for initially unresectable hepatic colorectal metastases.

Abstract

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: Yoshiya Fujimoto, Takayuki Akasu, Seiichiro Yamamoto, Shin Fujita, Yoshihiro Moriya
• Journal: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract (J Gastrointest Surg) Vol. 13 Issue 9 Pg. 1643-50 (Sep 2009) ISSN: 1873-4626 [Electronic] United States
• PMID: 19582514 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Fluorouracil

Topics

• Adult
• Aged
• Colorectal Neoplasms (mortality, pathology, therapy)
• Combined Modality Therapy
• Disease-Free Survival
• Female
• Fluorouracil (administration & dosage)
• Hepatectomy (methods, mortality)
• Humans
• Infusions, Intra-Arterial
• Kaplan-Meier Estimate
• Liver Neoplasms (mortality, secondary, therapy)
• Male
• Middle Aged
• Neoplasm Staging
• Probability
• Prognosis
• Retrospective Studies
• Risk Assessment
• Statistics, Nonparametric
• Survival Analysis
• Time Factors
• Treatment Outcome