Abstract
Between 1964 and 1981, seventy-two Japanese patients with gastric cancer associated with hepatic metastases, in whom the primary tumor had been resected, were treated in a nonrandomized manner at the Second Department of Surgery, Kyushu University Hospital. Fourteen received hepatic arterial infusion (HAI) of 5-FU and Mitomycin C (MMC) combined with systemic chemotherapy, 26 combination systemic chemotherapy of MMC, Futraful and PSK, 18 single drug (MMC) therapy, and 14 no chemotherapy. The average survival was 264 days in HAI combined with systemic chemotherapy, 208 in the combination systemic chemotherapy, 156 in the single drug therapy and 135 in those given no chemotherapy. One year survival and nine month survival rates were 21.4 per cent and 42.9 per cent in HAI combined with systemic chemotherapy, 11.5 per cent and 19.2 per cent in the combination systemic chemotherapy, 5.6 per cent and 11.1 per cent in the single drug therapy and 7.1 per cent and 14.3 per cent in the no chemotherapy group, respectively (HAI vs single drug therapy and no chemotherapy, p<0.01). Five of 14 patients treated with HAI combined with systemic chemotherapy showed a partial response (>50 per cent reduction in tumor size), and the average survival time was 335 days, while that of nonresponders was 224 days. Six of 14 patients treated with combination infusion therapy with MMC and 5-FU survived 314 days, as compared to 201 days for patients with infusion of 5-FU alone.
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Jaffe BM, Donegan WL, Watson F, Spatt JS. Factors influencing survival in patients with untreated hepatic metastases. Surg Gyne Obst 1968; 127: 1–11.
Patt YZ, Wallace S, Hersh EM, Hall SW, Menachem YB, Granmayeh M, McBride CM, Benjamin RS, Mavligid GM. Hepatic arterial infusion of corynebacterium pavum and chemotherapy. Surg Gyne Obst 1978; 178: 897–902.
Watkins E Jr, Khazei AM, Nahra KS. Surgical basis for arterial infusion chemotherapy of disseminated carcinoma of the liver. Surg Gyne Obst 1970; 130: 581–605.
Ansfield FJ, Ramirez G, Shibba JK, Bryan GT, Davis HL Jr, Wirtanen GW. Intrahepatic arterial infusion with 5-fluorouracil. Cancer 1971, 28: 1147–1151.
Japanese Research Society for Gastric Cancer: The General Rules for Gastric Cancer Study in Surgery and Pathology. Jpn J Surg 1981; 11: 127–139.
Kano T, Tamada R, Abe Y, Hiramoto Y. Notsuka T, Shiraishi M, Inoue F, Kumashiro R, Kodama Y, Inokuchi K. Postoperative longterm cancer chemotherapy (PLCC) extends lifespan of non-curatively resected patients with stage IV gastric cancer. Jpn J Surg 1982; 12: 203–207.
Burrows JH, Talley RW, San Diego DEL, Tucker WG. Infusion of fluorinated pyrimidines into hepatic artery for treatment of metastatic carcinoma of the liver. Cancer 1967; 20: 1886–1892.
Stehlin JS Jr, Hafstrom L, Greef PJ. Experience with infusion and resection in cancer of the liver. Surg Gyne Obst 1974; 138: 855–863.
Ensminger WD, Rosowsky A, Raso V, Levin DC, Glode M, Come S, Steele G, Frei E, A clinicalpharmacological evaluation of hepatic arterial infusion of 5-fluoro-2′-deoxyuridine and 5-fluorouracil. Cancer Res 1978; 38: 3784–3792.
Rapoport AH, Burleson RL. Survival of patients treated with systemic fluorouracil for hepatic metastases. Surg Gyne Obst 1970; 130: 773–777.
Okazaki N, Hattori N, Ono T, Kanda Y, Koyama S. Systemic chemotherapy of metastatic liver cancer. Jpn J Cancer and Chemotherapy 1974; 1: 347–355.
Fujimoto S, Miyazaki M, Kitsukawa Y, Okui K. Comparative efficacy of antitumor treatment for liver metastases from colorectal cancer. Jpn J Surg 1981; 11: 167–174.
Kinami Y, Miyazaki I. The superselective and selective one shot methods for treating inoperable cancer of the liver. Cancer 1978; 41: 1720–1727.
Misra NC, Jaiswall MSD, Singh RV, Das B. Intrahepatic arterial infusion of combination of Mitomycin-C and 5-fluorouracil in treatment of primary and metastatic liver carcinoma. Cancer 1977; 39: 1425–1429.
Sartoreli AC, Booth BA. The synergistic antineoplastic activity of combination of mitomycin with either 6-thioguanine or 5-fluorouracil. Cancer Res 1965; 25: 1393–1400.
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Kano, T., Kumashiro, R., Abe, Y. et al. Combination of hepatic arterial infusion and systemic chemotherapy for gastric cancer with synchronous hepatic metastases. The Japanese Journal of Surgery 14, 23–29 (1984). https://doi.org/10.1007/BF02469598
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DOI: https://doi.org/10.1007/BF02469598