Intra-arterial infusion chemotherapy using an implantable reservoir was used for 22 patients with liver
metastasis from September 1986 to March 1990. The material consisted of 8 subjects with
gastric cancer and 14 with
colorectal cancer. One had
metastasis in one lobe (H1), 10 had a few scattered
metastases in both lobes (H2) and 11 had numerous
metastases in both lobes (H3). In 5 cases, a reservoir was implanted to prevent the recurrence after
hepatectomy. Infusion
catheter was placed in the proper hepatic artery in 5 cases via the gastroduodenal artery at
laparotomy and it was carried out subcutaneously via the femoral artery in 17 cases. In all cases
intra-arterial infusion of
5-FU was continuously administered followed by intermittent one shot injection of ADM. The clinical effectiveness of the
therapy was well evaluated. One-year cumulative survival rate of all cases by Kaplan-Meier method was 55% and that of H2 cases was 78%. No recurrence was noted in post
hepatectomy cases. Eight cases (36.3%) showed remarkable complications, which made it impossible to continue
intra-arterial infusion chemotherapy: hepatic artery occlusion (3 cases),
infection (2 cases),
abdominal pain (1 case),
hematoma in the implanted site (1 case) and dislocation of the infusion
catheter (1 case). From the present study, it is considered that
intra-arterial infusion chemotherapy is a useful procedure for the control of liver
metastasis. Regimens for improved
chemotherapy and the maintenance of more useful and safer
catheters should therefore be investigated for further development of the therapeutical estimation.