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Hepatic artery ligation for liver metastasis in colorectal carcinoma
Author(s) -
Petrelli Nicholas J.,
Barcewicz Paul A.,
Evans James T.,
Ledesma Elihu J.,
Lawrence David D.,
Mittelman Arnold
Publication year - 1984
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19840315)53:6<1347::aid-cncr2820530622>3.0.co;2-e
Subject(s) - medicine , metastasis , gastroenterology , alkaline phosphatase , bilirubin , ligation , elevated alkaline phosphatase , performance status , liver function , colorectal cancer , liver function tests , lactate dehydrogenase , surgery , urology , cancer , biochemistry , chemistry , enzyme
From April 1975 to January 1982, 97 patients with > 50% of the liver involved with metastasis from colorectal carcinoma underwent hepatic artery ligation. The purpose was to evaluate median survival times in relation to performance status, synchronous intraabdominal metastasis, pulmonary metastasis, liver function tests (alkaline phosphatase, serum glutamic oxaloacetic transaminase (SGOT), lactate dehydrogenase (LDH), total bilirubin, and Dukes' staging. Results reveal that for performance status 0 to 1 (normal or symptoms, but ambulatory), median survival time was 12.3 months; status 2 to 3 (in bed < or >50% of time), 8.3 months; status 4 (100% bedridden), 2.6 months, ( P < 0.01). Median survival time in patients with only intrahepatic metastasis was 10 months versus 7 months for synchronous intraabdominal metastasis ( P < 0.01). For 20 patients with pulmonary metastasis undergoing hepatic artery ligation, the median survival time was 8.8 months ( P < 0.05). The median survival time in patients whose alkaline phosphatase was 2 times normal was 12.4 months, whereas, if alkaline phosphatase was 2 times to 4 times or >4 times normal, median survival times were 7.1 and 6.9 months, respectively ( P < 0.01). Factors that adversely affect survival for hepatic artery ligation are extrahepatic metastasis, poor performance status, and elevated liver function tests (alkaline phosphatase 2 times normal). The overall median survival time in this study is 9.5 months with certain subgroups achieving 12.4 months' survival. Cancer 53:1347‐1353, 1984.