LONG-TERM EFFECTS OF HEPATIC ARTERIAL INTERLEUKIN-2-BASED IMMUNOCHEMOTHERAPY AFTER POTENTIALLY CURATIVE RESECTION OF COLORECTAL LIVER METASTASES

Background: Our previous study of hepatic arterial infusion of interle ukin-2 (IL-2)-based immunochemotherapy demonstrated a high response ra te of patients with unresectable liver metastases. In this study, we a pplied this therapy to the prevention of liver recurrence in patients who underwent potentially curative resection of liver metastases. Stud y Design: A pilot study was conducted of 18 patients with liver metast ases from primary colorectal cancer who underwent potentially curative liver resection followed by adjuvant immunochemotherapy. The regimen consisted of a weekly hepatic arterial infusion of IL-2 (1.4-2.1 x 10( 6) U) and 5-fluorouracil (250 mg) and a bolus of mitomycin C (2-4 mg) for 6 months. Results: Among 18 patients, 14 are still alive with a me dian postoperative survival of 52 months (as of April 1998). The 5-yea r overall survival rate was 75%. Although recurrent cancer developed i n 6 of the 18 patients, no patients had recurrence in the residual liv er. This complete prevention of liver recurrence is believed to have c ontributed to the high 5-year survival rate (75%) as compared with the survival rate of patients treated with surgery alone (average, 30%-40 %) or with several other forms of adjuvant therapy. Conclusions: Inter leukin-2-based immunochemotherapy is useful in combination with liver resection for the prevention of liver recurrence in colorectal cancer patients with liver metascases. A multicenter randomized trial is reco mmended. (J Am Coll Surg 1998;187:271-275. (C) 1998 by the American Co llege of Surgeons)