Adjuvant regional chemotherapy after hepatic resection for colorectal metastases

Background: This study explored the possibility of achieving a better survi val rate and reduced recurrence in the remaining liver in patients with col orectal hepatic metastases undergoing hepatic resection. Adjuvant postopera tive regional chemotherapy was administered via the hepatic artery qr the p ortal vein. Methods: A retrospective study was performed on 174 patients after hepatic resection for colorectal metastases. These comprised 78 patients who had he patic artery infusion (HAI) chemotherapy (HAI group), 30 who had portal vei n infusion (PVI) chemotherapy (PVI group) and 66 who had no regional chemot herapy (resection alone group). The three groups were compared with one ano ther in terms of complications, survival rate and patterns of recurrence. Results: Severe complications did not occur at any point during adjuvant HA I or PVI chemotherapy. The 5-year disease-free survival rate of patients in the HAI, PVI and resection alone groups were 35, 13 and 9 per cent respect ively, including six hospital deaths. Patients in the HAI group showed sign ificantly improved recurrence rates in the remaining liver compared with th e resection alone group (P = 0.03), and more prolonged disease-free and ove rall survival than those in the PVI (P = 0.01 and P = 0.02 respectively) an d resection alone (P = 0.0001 and P = 0.0006 respectively) groups. Conclusion: This study suggests that adjuvant HAI chemotherapy after hepati c resection may have therapeutic potential for improved management of patie nts with colorectal metastases.