Repeated hepatic dearterialization for unresectable carcinomas of the liver: Report of a 10-year experience

The effectiveness of repeated hepatic dearterialization (RHD) therapy was e valuated in 26 patients with unresectable primary and secondary liver tumor s. RHD was performed in 12 patients with hepatocellular carcinoma (HCC), 7 with hepatic metastases from colorectal carcinoma, and 7 with hepatic metas tases from gastric carcinoma. It was repeatedly carried out by occluding th e hepatic artery for 1 h twice daily. All patients concurrently received an intra-arterial infusion of anticancer drugs. More than 50% remission of th e hepatic tumors, defined as a partial response (PR), was demonstrated in 8 patients (31%). A higher PR was seen in hepatic tumors from metastatic gas tric cancer (5 out of 7 patients; 71%). Most patients who suffered severe c omplications had HCC with liver cirrhosis. These preliminary results sugges t that RHD with intraarterial chemotherapy is an acceptable palliative trea tment for patients with unresectable liver metastasis from gastric cancer; however, the majority of patients with HCC are not responsive to such treat ment, primarily because most have underlying cirrhosis predisposing to the development of postoperative complications at an unacceptably high rate.