ADJUVANT TREATMENT IN PATIENTS WITH RESEC TION OF COLORECTAL LIVER METASTASES LITERATURE-REVIEW

Natural history of patients with colorectal liver metastases is not si gnificantly changed even by curative resection. The majority unfortuna tely relapse. The results of adjuvant treatment after resection were e valuated by analysis of 17 publications as well as by own data (60 pat ients). 340 patients were either treated by intraarterial (n=201), sys temic (n=82), intraportal (n=29) or intraperitoneal (n=28) chemoinfusi on (5-Fluorouracil or Floxuridine). An alternative approach was the tr eatment with specific immunotherapy using tumor vaccination (n=35) or monoclonal antibodies (n=20). Morbidity of adjuvant treatment includes local (chemical hepatitis, biliary sclerosis) and systemic (diarrhea, stomatitis) side effects. Technical complications could reach a level of up to 50 % in case of local administration. With exception of 6 st udies no comparison with a resection only group was performed.Despite postulated increase of survival and recurrence free time with historic al controls the results of current ongoing studies are needed before g eneral use of adjuvant treatment can be recommended.