RESECTION OF UNRESECTABLE SECONDARY LIVER-TUMORS - NEW FRONTIERS IN LIVER SURGERY

Background/Aim: Despite remarkable advances in diagnostic and therapeu tic techniques for metastatic liver disease, this disease remains a ch allenge for patients and surgeons. In this study we describe our exper ience in the management of 21 patients referred for treatment due to m etastatic disease, between 1992 and 1997, in Athens, Greece. Methodolo gy Patients diagnosed with unresectable liver tumors, received a stand ard treatment, which included neo-adjuvant locoregional immunochemothe rapy, surgical resection and adjuvant locoregional immuno-chemotherapy . Twenty clays after liver resection a standard protocol of combined l ocoregional immuno-chemotherapy was administered. The protocol include d 10 daily courses of transplenic (5-day) and transtumoral (5-day) imm unostimulation using proleukine suspended in lipiodol Urografin emulsi on. Five days later a standard dose of chemotherapeutical drugs suspen ded in lipiodol Urografin were given via the catheter of the hepatic a rtery. The above mode of adjuvant treatment was continued every 2 mont hs for the first postoperative year and every 3 months for the 2nd and 3rd postoperative years, every 4 months for the 4th and 5th postopera tive years. At the end of each treatment a blood test, which included the serum values of the tumors markers and an upper abdominal computer tomography was carried out for each patient. The treatment response w as evaluated accordingly, and divided into the following categories: c omplete response, partial response, stable disease and progressive dis ease. Results: There was no operative mortality. Sequelae and side eff ects secondary to treatment were minimal In group A and B of this stud y a 5-year survival rate of 65% and 20% and an overall response rate o f 80% and 68% in the above groups teas noted, respectively. Conclusion : The mode of management offered satisfactory results regarding qualit y of postoperative life.