Treatment of hepatic metastases in cancer of the colon and rectum. A preliminary report

Treatment of hepatic metastases in 31 patients with cancer of the colon and rectum consisted of wedge resection or partial hepatectomy in 2; systemic chemotherapy in 13; chemotherapy infusion of the hepatic artery in 9; and chemotherapy infusion combined with intermittent arterial occlusion in 7. Patients were not randomized with regard to type of treatment, yet the age and sex distribution of these patients was similar in the three groups receiving chemotherapy. One patient treated by resection of a solitary hepatic lesion had been living with no evidence of disease for over three years. None of the patients who received systemic chemotherapy exhibited evidence of objective response. Four of 9 patients who received chemotherapy infusion and 4 of 7 who received a combination of arterial occlusion and chemotherapy infusion survived for periods ranging from 18 to 32 months. Clinical evaluation of individual patients indicated that those having metastases confined to the liver (Stages II and III) who received intermittent arterial occlusion and chemotherapy infusion enjoyed longer periods of objective response and experienced fewer complications than did those treated by chemotherapy infusion alone.