Experience with continuous regional chemotherapy and hepatic resection as treatment of hepatic metastases from colorectal primaries. A prospective randomized study
✍ Scribed by M. Margaret Kemeny; David A. Goldberg; Scott Browning; Gerald E. Metter; Paula J. Miner; Jose J. Terz
- Publisher
- John Wiley and Sons
- Year
- 1985
- Tongue
- English
- Weight
- 471 KB
- Volume
- 55
- Category
- Article
- ISSN
- 0008-543X
No coin nor oath required. For personal study only.
✦ Synopsis
Sixty-five patients with hepatic metastases from colorectal primaries were studied in a prospective randomized fashion. The five patients with solitary metastases all had resection of metastases and 50% were randomized to pump therapy. Of the 16 patients with multiple resectable metastases, 7 had pump only and 9 had resection plus pump. Although the difference was not significant, there was a trend of improved survival for the patients with resection plus pump. For the patients with unresectable disease, those patients with positive portal nodes had poor survival matching those patients with extra hepatic metastases. Patients with unresectable disease treated with pump had a 73% therapeutic response rate and a median siirvival of 22 months. Significant complications included chemical hepatitis and biliary stenosis. The long-term efficacy of continuous hepatic artery infusion versus the hazards of treatment and the financial cost will need further investigation.
Cancer 5 5 1 265-1 270, 1985.
EPATIC METASTASES are a major cause of death in H patients with metastatic colorectal carcinoma. Regional therapy of these metastases has become more feasible with the development of a totally implantable pump that can continuously infuse the hepatic artery.
Several preliminary nonrandomized studies have suggested the efficacy of continuous hepatic artery infusion (CHAI) of floxuridine (FUDR) via the implantable pump to decrease and even eradicate the liver metastases'-'. More than 2 years ago we started a prospective randomized protocol at the City of Hope, studying the efficacy of hepatic resection and CHAI of FUDR for treatment of hepatic metastases. This article, which presents preliminary data, reviews the experience we have had with this protocol.