THE VALUE OF POSTOPERATIVE HEPATIC ARTERIAL INFUSION FOLLOWING CURATIVE LIVER RESECTION

Despite the increasing success of liver resection in treatment of meta static colorectal cancer, at least 50% of patients will recur again in the remaining liver. In a nonrandomized prospective study we examined the benefit of regional adjuvant chemotherapy compared with surgical resection alone. Data from 81 consecutive patients who received curati ve liver resection and from 29 additional patients who underwent palli ative liver resection were collected. Intraarterial adjuvant treatment with FUDR or 5-Fluorouracil was performed after liver resection in 60 patients. Mortality (5,5 %) and morbidity (30 %) were not increased b y catheter implantation. Five or more cycles of intraarterial chemothe rapy were completed in 39 (89 %) of the curative resected patients. De pending on the treatment schedule the most frequent local and systemic side effects were stomatitis (13 %) hepatobiliary toxicity and in two patients biliary sclerosis after a FUDR treatment of 14 days. In cura tive resected patients median time to intrahepatic recurrence was sign ificantly delayed by adjuvant arterial treatment from 17 to 63 months (p = 0,015). Median survival time (overall 48 months) was increased fr om 33 months after surgery to 52 months (p = 0,064) and in case of 5 o r more treatment cycles to 54 months (p=0,046).