ADJUVANT HEPATIC ARTERIAL INFUSION CHEMOTHERAPY AFTER CURATIVE RESECTION OF COLORECTAL LIVER METASTASES

We performed a prospective study of adjuvant hepatic arterial infusion chemotherapy after resection of colorectal liver metastases. We place d hepatic arterial infusion ports in 20 consecutive patients undergoin g curative resection of colorectal liver metastases. The chemotherapy regimen was a weekly bolus of 5-fluorouracil (15 mg/kg) for 6 months. The median follow-up has been 33 months. Nine of the 18 evaluable pati ents (50%) have developed recurrent colorectal cancer. The liver was t he only site of failure in 3 of 18 patients (17%), and extrahepatic re currences occurred in 6 of 18 patients (33%). Ah patients without recu rrence are alive. The median survival of the patients without recurren t disease is 39 months, compared with 27 months for those with recurre nt metastatic disease (p <0.01). in patients who received adjuvant hep atic arterial infusion chemotherapy compared with historical controls treated with surgery alone, we have observed a decreased incidence of recurrent disease after liver resection for metastases. We recommend t hat patients who undergo hepatic resection for colorectal metastases b e considered for postoperative adjuvant chemotherapy to decrease the l ikelihood of recurrence and to improve survival.