An Effective Case of Combined Arterial and Portal Infusion Chemotherapy for Sigmoid Colon Cancer with Multiple Liver Metastases

Yoshikazu Suzuki, Shigehiko Yagi, Keiichi Shinozaki, Kazuhide Iwakawa, Kenzi Inoue, Yasuyuki Shimahara, Nobuaki Kobayashi

First Department of Surgery, Ehime University School of Medicine

A 74-year-old man who underwent sigmoidectomy and was followed by combined hepatic arterial and portal infusion chemotherapy for Stage V sigmoid colon cancer accompained with multiple liver metastases. For the infusion chemotherapy, we inserted a catheter in the gastroduodenal artery and another catheter in the inferior mesenteric vein, and the reservoirs connecting with catheters were placed in the abdominal subcutaneou space for postoperative use. Before closing the abdominal wall, 4 mg of mitomycin-C (MMC) was infused through both the reservoirs. Fifty milligram of cisplatin (CDDP) and 250 mg of 5-fluorouracil (5-FU) were infused through these reservoirs at 2,5 and 9 weeks after the operation. After these treatments, metastatic liver tumors were not detected by computed tomography (CT) in the second postoperative month. The blood levels of carcinomebryonic antigen (CEA) and carbohydrate antigen (CA19-9) decreased markedly from 240 ng/ml and 450 U/ml to 16.5 ng/ml and 141 U/ml, respectively, and continued to decrease up to the 4th postoperative month. These findings suggest that combined hepatic artery and portal infusion chemotherapy may become an effective and useful modality in the treatment of multiple liver metastases of colon cancer.

Key words
liver metastatis of sigmoid colon cancer, intra-portal infusion chemotherapy, intra-arterial infusion chemotherapy

Reprint requests
Yoshikazu Suzuki First Department of Surgery, Ehime University School of Medicine
Shitsukawa, Shigenobu-cho, Onsen-gun, Ehime, 791-02 JAPAN

Accepted
December 8, 1993

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