Hepatic artery ligation and portal vein infusion for liver metastases from colon cancer.

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Abstract
Localized treatment of liver metastases from colon cancer has yielded better results than has systemic therapy. Nineteen patients with metastatic colon cancer whose bulk disease was limited to the liver but was not amenable to surgical resection are reported. Many of these patients had the following poor prognostic features: 14 had > 30% replacement of the liver, 5 had poorly differentiated tumor, and 5 had previously failed to respond to systemic chemotherapy. All were treated with hepatic artery ligation and portal vein infusion of chemotherapy (mitomycin C and 5-fluorouracil). Two patients (10%) died within 1 mo. postoperatively. The remaining 17 patients all improved clinically and demonstrated a marked decrease in carcinoembryonic antigen (CEA) levels. Based on follow-up physical exam, liver function tests, computed tomographic scan and/or laparotomy, there were 2 complete responses, 10 partial responses, 4 improved and 1 indeterminate, for an objective response rate of 63%. Median survival of all patietns was 13 mo. after hepatic artery ligation and 14 mo. after diagnosis of liver metastases, with 4 patients still alive at 13+, 16+, 41+ and 61+mo. after hepatic artery ligation. This form of therapy apparently is an effective, well-tolerated alternative for patients with unresectable liver metastases.