Abstract
Since the first description of regional chemotherapy of the liver, many reports [1–4] have demonstrated more theoretical advantage than clinical benefits. Not toxic but catheter complications seemed to limit the potential of the new method [5]. Totally implantable drug pumps and ports (Infusaid, Shiley Infusaid, Inc., Norword, Mass., USA) in the late reduced the risk of technical problems. Using continuous intraarterial floxuridine (FUDR) with an extraction of more than 90% in the liver [6], response rates of 30%–88% were reported [7, 8]. A methodological standard for the first time allowed reliable clinical studies[9–12]. Local treatment seemed superior to conventional systemic chemotherapy, although prolongation of survival was only demonstrated using historical control groups. Our own investigations in this field have tremendously increased the number of patients undergoing hepatic surgery in our institution. Since 1982 we have treated 516 patients with hepatic only malignancies, of whom 128 have undergone liver resection or transplantation.
We thank Peter Kempkes for the assistance in computerized analysis of data and preparation for publication.
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References
Sullivan RD, Norcross JW, Watkins E (1964) Chemotherapy of metastatic liver cancer by prolonged hepatic-artery infusion. N Engl J Med 270:321–327
Oberfield RA, McCaffrey JA, Polio JP, Clouse ME, Hamilton T (1979) Prolonged and continuous percutaneous intraarterial hepatic infusion chemotherapy in advanced metastatic liver adenocarcinoma from colorectal primary. Cancer 44:414–423
Patt YZ, Mavligit GM, Chuang VP, Wallace S, Johnston S, Benjamin RS, Valdivieso M, Hersh EM (1980) Percutaneous hepatic arterial infusion (HAI) of mitomycin C and floxuridine (FUDR)–an effective treatment for metastatic colorectal carcinoma in the liver. Cancer 46:261–265
Reed ML, Vaitkevicius VK, Al-Sarraf M, Vaughn CB, Singhakowinta A, Sexon-Porte M, Izbicki R, Baker L, Straatsma GW (1981) The practicality of chronic hepatic artery infusion therapy of primary and metastatic hepatic malignancies. Cancer 47:402–409
Watkins E, Khazei AM, Nahra KS (1970) Surgical basis for arterial infusion chemotherapy of disseminated carcinoma of the liver. Surg Gynec Obstet 130:581–605
Ensminger WD, Roskowsky A, Raso V et al. (1978) A clinical-pharmacological evaluation of hepatic arterial infusions of 5-fluoro-2-deoxyuridine and 5-fluorouracil. Cancer Res 38:3784–3792
Balch CM, Urist MM, Soong SJ, McGregor M (1983) A prospective phase II clinical trial of continuous FUDR + regional chemotherapy for colorectal metastases to the liver using a totally implantable drug infusion pump. Ann Surg 198:567
Niederhuber JE, Ensminger W, Gyves J, Thrall J, Walker S, Cozzi E (1984) Regional chemotherapy of colorectal cancer metastatic to the liver. Cancer 53:1336–1343
Cohen AM, Schaeffer N, Higgins J (1986) Treatment of metastatic colorectal cancer with hepatic artery combination chemotherapy. Cancer 57:1115–1117
Johnson LP, Rikvin SE (1985) The implanted pump in metastatic colorectal cancer of the liver: risk versus benefit. Am J Surg 149:595–598
Shepard KV, Levin B, Karl RC, Faintuch J, DuBrow RA, Hagle M, Cooper RM, Beschorner J, Stablein D (1985) Therapy for metastatic colorectal cancer with hepatic artery infusion chemotherapy using a subcutaneous implanted pump. J Clin Oncol 3:161–169
Schwarz SI, Jones LS, McLune CS (1985) Assessment of treatment of intrahepatic malignancies using chemotherapy via an implantable pump. Ann Surg 201:560–567
Pettavel J, Morgenthaler F (1978) Protracted arterial chemotherapy of liver tumors-an experience of 107 cases over a 12 year period. Prog Clin Cancer 7:217–233
Gennari L, Poci R, Bozze HF Veronesi U (1982) Proposal for a clinical classification of liver metastases. Tumori 68:443–449
Lahr CJ, Soong SJ, Cloud G, Smith JW, Urist MM, Balch CM (1983) A multifactorial analysis of prognostic factors in patients with liver metastases from colorectal carcinoma. J Clin Oncol 1:720
Hottenrott C, Lorenz M (1987) Stellenwert der regionalen Chemotherapie der Leber. Z Gastroenterol 25:364–373
Hohn DC, Rayner AA, Economon JS, Ignoffo RJ, Lewis BJ, Stagg RJ (1986) Toxicities and complications of implanted pump hepatic arterial and intravenous floxuridine infusion. Cancer 57:465–470
Herrmann G, Lorenz M, Kirkowa-Reimann M, Hottenrott C, Hübner K (1987) Morphological changes after intraarterial chemotherapy of the liver. Hepato-gastroenterology 34:5–9
Balch CM, Christ MM (1984) Intraarterielle Chemotherapie mit einer implantierbaren Infusionspumpe bei Lebermetastasen colorectaler Tumoren und Hepatomen. Chirurg 55:485–493
Kemeny N, Daly J, Reichmann B, Geller N, Botet J, Odermann P (1987) Intrahepatic or systemic infusion of fluorodeoxyuridine in patients with liver metastases from colorectal carcinoma. Ann Intern Med 107:459–465
Hegemann G, Mühe E (1976) Extirpation von Metastasen. Langenbecks Arch Chir 342:261–268
Adson MA, von Herden JA (1980) Major hepatic resection for metastatic colorectal cancer. Ann Surg 191:576–583
Iwatsuki S, Shaw B, Storzl T (1983) Experience with 150 liver resections. Ann Surg 197:247–253
Kemeny MM, Goldberg D, Beatty JD et al. (1986) Results of a prospective randomized trial of continuous regional chemotherapy and hepatic resection as treatment of hepatic metastases from colorectal primaries. Cancer 57:492–498
Hodgson WJB, Friedland M, Ahmed T, Mittelmann A, Berman H, Katz S, Morgan J, Byrne D (1986) Treatment of colorectal hepatic metastases by intrahepatic chemotherapy alone or as an adjuvant to complete or partial removal of metastatic disease. Ann Surg 210:420–425
Jaffe BM, Donegan WL, Watson F, Spratt J (1968) Factors influencing survival in patients with untreated hepatic metastases. Surg Gynecol Obstet 127:1–11
Lorenz M, Hottenrott C, Seufert RM, Kirkowa-Reimann M, Encke A (1986) Dauerhafter intravenöser oder intrarterieller Zugang mit einer subkutan liegenden implantierbaren Infusionskammer. Dtsch Med Wochenschr 111:772–779
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Hottenrott, C., Lorenz, M., Baum, R.P., Kirkowa-Reimann, M., Herrhausen, T., Inglis, R. (1990). Six Years of Experience with Local Chemotherapy of the Liver. In: Jakesz, R., Rainer, H. (eds) Progress in Regional Cancer Therapy. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-74818-9_10
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DOI: https://doi.org/10.1007/978-3-642-74818-9_10
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