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Results of Preoperative Hepatic Arterial Infusion Chemotherapy in Patients Undergoing Liver Resection for Colorectal Liver Metastases

  • Hepatic and Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Although hepatic artery infusion chemotherapy (HAIC) of floxuridine (FUDR) for colorectal liver metastases (CLM) can produce high response rates, data concerning preoperative HAIC are scarce. The aim of this study was to assess the feasibility and results of liver resection after preoperative HAIC with FUDR.

Methods

Between 1995 and 2004, 239 patients with isolated CLM received HAIC in our institution. Fifty of these patients underwent subsequent curative liver resection (HAIC group). Short- and long-term results of the HAIC group were compared with the outcomes of 50 patients who underwent liver resection for CLM without preoperative chemotherapy.

Results

Postoperative morbidity rate were comparable between the two groups. Overall disease-free survival at 1 and 3 years after hepatectomy were 77.5% and 57.5% in the HAIC group and 62.9% and 37% in the control group (P = .036). Overall survival from diagnosis of CLM at 1, 3, and 5 years were 97%, 59%, and 49% in the HAIC group versus 94%, 48%, and 35% in the control group (P = .097). When patients were stratified according to clinical-risk scoring (CRS) system, patients with more advanced disease at the time of liver resection (CRS ≥3) had a median survival of 41 months in the HAIC group (n = 37) and 35 months in the control group (n = 34) (P = .031).

Conclusions

HAIC of FUDR does not negatively affect the outcome of subsequent liver resection. Preoperative HAIC of FUDR may reduce liver recurrence rate and improve long-term survival in patients with more advanced liver disease.

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Authors and Affiliations

  1. Department of Surgery, Liver Unit, Scientific Institute San Raffaele, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy

    Carlo Pulitanò MD, Marcella Arru MD, Marco Catena MD, PhD, Eleonora Guzzetti MD, Gianfranco Ferla MD & Luca Aldrighetti MD, PhD

  2. Department of Oncology, Scientific Institute San Raffaele, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy

    Giordano Vitali MD, Monica Ronzoni MD & Eugenio Villa MD

  3. Department of Radiology, Scientific Institute San Raffaele, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy

    Massimo Venturini MD

Authors
  1. Carlo Pulitanò MD
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  2. Marcella Arru MD
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  3. Marco Catena MD, PhD
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  4. Eleonora Guzzetti MD
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  7. Massimo Venturini MD
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  8. Eugenio Villa MD
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  9. Gianfranco Ferla MD
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  10. Luca Aldrighetti MD, PhD
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Corresponding author

Correspondence to Luca Aldrighetti MD, PhD.

Additional information

Part of this article was presented at the International Hepato-Pancreato-Biliary Association, 7th World Congress in Edinburgh, Scotland, September 3–7, 2006.

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Pulitanò, C., Arru, M., Catena, M. et al. Results of Preoperative Hepatic Arterial Infusion Chemotherapy in Patients Undergoing Liver Resection for Colorectal Liver Metastases. Ann Surg Oncol 15, 1661–1669 (2008). https://doi.org/10.1245/s10434-008-9882-5

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  • DOI: https://doi.org/10.1245/s10434-008-9882-5

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