Published online Oct 15, 1998. doi: 10.3748/wjg.v4.iSuppl2.35
Revised: May 12, 1998
Accepted: June 9, 1998
Published online: October 15, 1998
AIM: To explore the therapeutic effect of chemoembolization in hepatic metastases in colorectal carcinoma.
METHODS: Forty patients underwent chemoembolization of metastatic liver lesion from colorectal carcinoma. Selective angiography of the hepatic a rtery was performed to identify the feeding vessels of the metastatic lesion. The injected chemoemulsum consisted of 100 mg 5-fluorouracil, 10 mg mit omycin C and 10 mL lipiodol ultra fluid in a total volume of 30 mL. Gel foam embolization then followed until stagnation of blood flow was achieved. Patients were evaluated for response, over all survival, and side effects.
RESULTS: Overall median survival time from date of first chemoembolization was ten mo. Median survival time of cirrhotic patients with class A and B by Child-Pugh classification was 24 and 3 mo, respectively. The difference was significant, (P < 0.01). Patients with metastatic disease confined to the liver did better than those who also had extrahepatic disease, with median survivals of 14 and 3 mo, respectively (P < 0.02). There were significant differences in that median survival of patients with hypervascular metastases was longer than that of patients with hypovascular metastases. The most common side effects were transient fever, abdominal pain and fatigue. Three patients died within one mo from the procedure.
CONCLUSION: The therapeutic effect of systemic chemotherapy in hepatic metastases of large intestinal carcinoma was not satisfactory and there were more side effects, whereas the therapeutic effect of selective chemoembolization was promising and there were less side effects. Selective chemoembolization may be an effective first-line therapy in hepatic metastases of large intestinal carcinoma.