Selective chemoembolization in the management of hepatic metastases in refractory colorectal carcinoma: A phase II trial

Pedro M. Sanz-Altamira, Liam D. Spence, Mark S. Huberman, Marshall R. Posner, Glenn Steele, Laura J. Perry, Keith E. Stuart

Research output: Contribution to journalArticlepeer-review

92 Scopus citations

Abstract

PURPOSE: Metastatic involvement of the liver frequently determines the evolution of the clinical picture in colorectal cancer patients. We examined the efficacy and toxicity of chemoembolization in this setting, identifying prognostic factors to define patients most likely to benefit from the procedure. METHODS: Forty patients underwent chemoembolization of metastatic liver lesions from colorectal carcinoma. Selective angiography of the hepatic artery was performed to identify the feeding vessels of the metastatic lesions. The injected chemoemulsion consisted of 1,000 mg of 5-fluorouracil, 10 mg of mitomycin C, and 10 ml of ethiodized oil in a total volume of 30 ml. Gelfoam embolization then followed, until stagnation of blood flow was achieved. Patients were evaluated for response, overall survival, and toxicities. RESULTS: Overall median survival from date of first chemoembolization was ten months. Factors that predicted a longer median survival included favorable performance status (24 months), serum alkaline phosphatase and lactate dehydrogenase level less than three times normal (24 and 12 months, respectively), and metastatic disease confined to the liver (14 months). Most patients tolerated the procedure well. The most common side effects were transient fevers, abdominal pain, and fatigue. Three patients died within one month from the procedure. CONCLUSION: This study suggests that chemoembolization of hepatic metastases in colorectal cancer should be further evaluated; it may be beneficial in patients who have failed systemic chemotherapy, have a good performance status, and have metastatic disease confined to the liver.

Original languageEnglish
Pages (from-to)770-775
Number of pages6
JournalDiseases of the Colon and Rectum
Volume40
Issue number7
DOIs
StatePublished - Jul 1997
Externally publishedYes

Keywords

  • 5- Fluorouracil
  • Chemoembolization
  • Colorectal carcinoma
  • Ethiodized oil
  • Gelfoam
  • Liver metastases
  • Mitomycin C

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