Sequence of regional chemotherapy and surgery. Management of colorectal adenocarcinoma confined to the liver

E. Tilchen, Y. Z. Patt, C. M. McBride, S. Wallace, V. Chuang and C. M. Mavligit

Four patients with clinically nonresectable unilobar hepatic metastases from colorectal cancer were treated with a sequentially combined approach of intrahepatic arterial chemotherapy followed by surgery. Partial regression (greater than or equal to 50%) induced by chemotherapy and associated with a decline in plasma carcinoembryonic antigen level was followed successfully by a complete hepatic tumor resection in three out of four patients. All three patients continue to be free of disease from 13+ to 21+ months. This combined approach may improve the salvage rate of patients with regionally confined hepatic metastases.