[Evaluation of intra-arterial infusion chemotherapy for liver metastasis from gastric cancer FEM--combination therapy of 5 FU, Epirubicin and MMC].
OBJECTIVE
We evaluated the effectiveness of FEM (5-FU, Epirubicin, MMC) therapy.


METHODS
One hundred ten cases of liver metastasis from gastric cancer were collected from January, 1977 until June, 2001 (synchronous: 74 cases, asynchronous: 36 cases). Twenty-nine cases were H1, 20 cases were H2 and 61 cases were H3.


METHODS
The patients were divided into the following groups: Group A: Resection of the primary lesion and hepatic resection (n = 9); Group A1: Hepatic resection only (5 cases), Group A2: Hepatic resection and intra-arterial infusion (4 cases). Group B: Resection of the primary lesion (n = 67); Group B1: Resection of the primary lesion only (46 cases), Group B2: Intra-arterial infusion (21 cases). In Groups A2 and B2, FEM therapy was applied to A2a (3 cases) and B2a (8 cases). Non-FEM therapy was applied to A2b (1 case) and B2b (13 cases). Group C consisted of 34 cases in which resection of the primary lesion was not undertaken. Survival rates were then compared.


RESULTS
One-year survival rates and 50% survival period for each group were as follows: Group A: 33%, 5.9 months; Group B: 22%, 4.8 months; and Group C: 6%, 3.9 months, respectively. Five patients from Groups A2a and B2a survived for one year or longer.


CONCLUSIONS
1. The prognosis with liver metastasis from gastric cancer, even with a number of therapies, is not promising. 2. Resection of the primary lesion along with hepatic intra-arterial infusion therapy (in addition to hepatic resection), especially in combination with FEM therapy, provided an extended survival.
Takada
Joji
J
Dept. of Surgery, Nikko Memorial Hospital.
Katsuki
Yoshio
Y
Hamada
Hiromi
H
Tsuji
Yasushige
Y
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D015251:Epirubicin / Q000008:administration & dosage*; D005472:Fluorouracil / Q000008:administration & dosage*; D006498:Hepatectomy; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D016685:Mitomycin / Q000008:administration & dosage*; D013274:Stomach Neoplasms / Q000473:pathology*; D015996:Survival Rate
D015251:Epirubicin; D016685:Mitomycin; D005472:Fluorouracil