Japanese Journal of Clinical Oncology, Vol 27, Issue 5 331-335, Copyright © 1997 by Foundation for Promotion of Cancer Research
T Akasu, Y Moriya and T Takayama
The prognosis of patients with unresectable liver metastases is poor, even
if hepatic arterial infusion chemotherapy (HAI) or systemic chemotherapy is
administered. A pilot study was performed to evaluate the feasibility and
efficacy of multimodality therapy with hepatectomy after HAI and portal
embolization for such patients. Eight patients with colorectal carcinoma
and synchronous unresectable liver metastases underwent resection of the
primary tumor and placement of a pump, followed by HAI with 5-fluorouracil
and mitomycin C. Owing to shrinkage of the liver metastases, two patients
could undergo extended right hepatic lobectomy after portal embolization,
which was deemed to be essential to prevent post-operative hepatic failure.
The median survival time of the eight patients was 30 months, with a
response rate of 75%. Complications including sclerosing cholangitis and
duodenal ulcer were observed in five patients (63%). Additional hepatectomy
could be performed successfully after portal embolization without morbidity
in two patients. These two patients are still alive more than 6 years after
initiation of HAI and have been free of disease for more than 5 years after
hepatectomy. Hepatectomy after HAI and portal embolization is feasible and
may be an option to cure selected patients with initially unresectable
liver metastases.
ORIGINAL ARTICLE
A pilot study of multimodality therapy for initially unresectable liver metastases from colorectal carcinoma: hepatic resection after hepatic arterial infusion chemotherapy and portal embolization
Department of Surgery, National Cancer Center Hospital, Tokyo, Japan.
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