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Hepatic artery infusional chemotherapy in patients with unresectable colorectal liver metastases and extrahepatic disease
Author(s) -
Ammori John B.,
D'Angelica Michael I.,
Fong Yuman,
Cercek Andrea,
Dematteo Ronald P.,
Allen Peter J.,
Kingham T. Peter,
Paty Philip B.,
Jarnagin William R.,
Kemeny Nancy E.
Publication year - 2012
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23204
Subject(s) - medicine , chemotherapy , colorectal cancer , palliative chemotherapy , gastroenterology , surgery , cancer
Background and Objectives Hepatic arterial infusional (HAI) chemotherapy combined with systemic chemotherapy is effective palliative therapy for unresectable colorectal cancer liver metastases (CRLM). Some patients considered for HAI have evidence of minimal extrahepatic disease (EHD), and the role of HAI in these situations is unknown. Methods All patients with unresectable CRLM treated with HAI and systemic chemotherapy from 2000 to 2009 were included. Survival of patients who were ultimately proven to have low‐volume EHD was compared to those without EHD. Results Three hundred seventy‐three patients were included in this study. Seventy‐nine percent of patients were previously treated with chemotherapy. One hundred forty‐five patients (39%) ultimately proved to have EHD. Median overall survival from HAI pump placement in patients without EHD was 32 months compared to 16 months for patients with EHD, P < 0.001. Median overall survival from HAI pump placement in patients with a single site of EHD was 18 months compared to 9 months for those with multiple sites of EHD, P = 0.01. Conclusions In this study of heavily pre‐treated patients, overall survival was favorable in patients who proved to have EHD at one site. J. Surg. Oncol. 2012; 106: 953–958. © 2012 Wiley Periodicals, Inc.