Adjuvant hepatic arterial infusion

Adjuvant hepatic arterial infusion following liver resection has been employed without success to improve long-term survival. In a randomized controlled series of 226 patients, Lorenz et al. (1998) reported no improvements in response with postoperative arterial infusion of 5-FU (1000 mg/m per day -1-5 days) and folinic acid (200 mg/m per day -1-5 days). Systemic chemotherapy given after resection of hepatic metastases was compared to combined systemic and hepatic arterial chemotherapy in another randomized trial of 156 patients reported by Kemeny et al. (1999). The 2-year survival rates improved from 72% to 86% between the systemic therapy group and the combined systemic/hepatic... 

Scaife CL, Curley SA, Izzo F, et al (2003) Feasibility of adjuvant hepatic arterial infusion of chemotherapy after radiofrequency ablation with or without resection in patients with hepatic metastases from colorectal cancer. Ann Surg Oncol 10 348-354... 

Because approximately two-thirds of patients who undergo resection of hepatic metastases will have disease recurrence, adjuvant systemic and hepatic arterial infusion chemotherapy have been studied in an attempt to improve long-term outcomes. A randomized trial that compared 6 months of hepatic floxuridine and dexamethasone plus TV fluorouracil with leucovorin to TV fluorouracil with leucov-orin alone following resection of hepatic metastases in 156 patients showed improved 2-year DPS (86% vs. 72%) and hepatic recurrence-free survival at 2 years (90% vs. 60%) with the combined therapy. Many practitioners offer adjuvant chemotherapy to select patients following potentially curative hepatic resection, but further studies, especially those involving more active agents, are needed to determine an optimal treatment regimen. ... 

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