Hepatic artery ligation for liver metastasis in colorectal carcinoma

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.

[1]  Davis Hl.  Chemotherapy of large bowel cancer. , 1982 .

[2]  R. Goslin,et al.  Factors influencing survival in patients with hepatic metastases from adenocarcinoma of the colon or rectum , 1982, Diseases of the colon and rectum.

[3]  J. Byfield,et al.  Intra‐arterial chemotherapy using an implantable infusion pump and liver irradiation for the treatment of hepatic metastases , 1982, Cancer.

[4]  W. Mietlowski,et al.  Levamisole as an adjuvant to chemotherapy in extensive bronchogenic carcinoma. A veterans administration lung cancer group study , 1982, Cancer.

[5]  D. Morton,et al.  Hepatic resection of metastatic colorectal carcinoma: a ten-year experience. , 1982, Archives of surgery.

[6]  S. Wallace,et al.  THE PALLIATIVE ROLE OF HEPATIC ARTERIAL INFUSION AND ARTERIAL OCCLUSION IN COLORECTAL CARCINOMA METASTATIC TO THE LIVER , 1981, The Lancet.

[7]  R. Gelber,et al.  The palliation of hepatic metastases: results of the Radiation Therapy Oncology Group pilot study. , 1978, International journal of radiation oncology, biology, physics.

[8]  U. Tylén,et al.  Transient hepatic dearterialization followed by regional intra-arterial 5-fluorouracil infusion as treatment for liver tumors. , 1981, Annals of surgery.

[9]  S. Wallace,et al.  Percutaneous hepatic arterial infusion (HAI) of mitomycin C and floxuridine (FUDR): An effective treatment for metastatic colorectal carcinoma in the liver , 1980, Cancer.

[10]  D. Nitti,et al.  Temporary occlusion of the hepatic artery plus infusion and systemic chemotherapy for inoperable cancer of the liver. , 1980, International surgery.

[11]  S. Moss,et al.  Results of a prospective randomized study of hepatic artery infusion with 5-fluorouracil versus intravenous 5-fluorouracil in patients with hepatic metastases from colorectal cancer: A Central Oncology Group study. , 1979, Surgery.

[12]  S. Moss,et al.  Results of a Prospective Ramdomized Study of Hepatic Artery Infusion with 5-Fluorouracil vs. Intravenous 5-Fluorouracil in Patients with Hepatic Metastases from Colo-rectal Cancer , 1979 .

[13]  I. Taylor.  Cytotoxic perfusion for colorectal liver metastases , 1978, The British journal of surgery.

[14]  J. Foster,et al.  Solid liver tumors. , 1977, Major problems in clinical surgery.

[15]  D. Morton,et al.  Hepatic artery ligation and 5-fluorouracil infusion for metastatic colon carcinoma and primary hepatoma. , 1976, American journal of surgery.

[16]  R. Nichols,et al.  The present position of the neomycin-erythromycin bowal prep. , 1975, The Surgical clinics of North America.

[17]  M. Silverstein,et al.  Hepatic artery ligation and postoperative chemotherapy for hepatic metastases: Clinical and pathophysiological results , 1975, Cancer.

[18]  B. Cady,et al.  Regional infusion chemotherapy of hepatic metastases from carcinoma of the colon. , 1974, American journal of surgery.

[19]  P. Kärkölä,et al.  Treatment of patients with hepatic tumors and jaundice by ligation of the hepatic artery. , 1974, Archives of surgery.

[20]  R. Mulcare,et al.  Treatment of Primary and Secondary Liver Cancer by Hepatic Artery Ligation and Infusion Chemotherapy , 1973, Annals of surgery.

[21]  R. Condon,et al.  Hepatic artery ligation and cytotoxic infusion in treatment of liver metastases. , 1972, Archives of surgery.

[22]  C. Rudenstam,et al.  Evaluation of hepatic dearterialization in primary and secondary cancer of the liver. , 1972, American journal of surgery.