The Significance of Early Intermittent Hepatic Arterial Infusion Chemotherapy after Resection for Hepatic Metastases from Colorectal Cancer

Kazuo Hatsuse, Makoto Maemura, Satoshi Shouno, Michinori Murayama, Yoshihiro Sakai, Hideki Aoki, Noriyasu Komine, Takeyuki Idei, Minoru Kakihara, Syoetsu Tamakuma

First Department of Surgery, National Defense Medical College

We examined the efficacy of early intermittent hepatic arterial infusion chemotherapy (IHAIC) after resection of metastases from colorectal cancer for prevention of early recurrence in the remnant liver. Thirty-two patients were divided into 2 groups consisting of 20 patients with hepatectomy (group A), and 12 patients with hepatectomy followed by IHAIC (group B). Fluorouracil was given every 2 weeks in addition to mitomycin C every 4 weeks, and doxorubicin every 8 weeks in IHAIC. In group A, 17 patients had recurrences and in 10 of them, the site of recurrence was in the remnant liver. In group B, 5 patients had recurrences and in 4 of them, the site of recurrence was in the remnant liver. The cumulative disease-free survival rates with respect to remnant liver recurrence for group A and B, respectively, were 1 year, 28% and 79%; 2 years, 18% and 53%; 3 years, 0% and 53%. The differences in the disease-free survival rates between the 2 groups were statistically significant (p<0.001, 0.05). The cumulative survival rates, respectively, were 1 year, 82% and 100%; 2 years, 21% and 44%; 3 years, 10% and 44%. The differences were not statistically significant. We concluded that postoperative IHAIC was effective for prevention of early recurrence in the remnant liver. But more studies of chemotherapeutic agents and infusion routes are necessary to improve prognosis in view of the survival rate.

Key words
liver metastasis of colorectal cancer, hepatic resection, remnant liver recurrence after hepatectomy, adjuvant chemotherapy, intermittent hepatic arterial infusion chemotherapy

Reprint requests
Kazuo Hatsuse First Department of Surgery, National Defense Medical College
3-2 Namiki, Tokorozawa, 359 JAPAN

Accepted
May 13, 1992

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