title: Adjuvant hepatic arterial infusion chemotherapy after curative resection for Dukes C colorectal cancer: a pilot study.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effect and the toxicity of prophylactic adjuvant hepatic arterial infusion chemotherapy (HAIC) on liver metastases and on overall survival of Dukes C colorectal cancer patients.
  
  
  METHODS
  Ninety patients in whom Dukes C colorectal cancer was diagnosed and were treated with curative resection between 1993 and 1997 underwent HAIC. The HAIC regimen consisted of a 24-hour continuous infusion of 1500 mg of 5-fluorouracil, administered once a week for 8 weeks, utilizing a portable infusion drug delivery system to ambulatory patients. Patients to whom 7 g or more of 5-fluorouracil could be given were included in the HAIC group, which resulted in 70 of the 90 patients being in this group. The HAIC group overall survival and liver recurrence rates were compared with those of 62 non-treated cases of Dukes C, which formed the non-HAIC control group.
  
  
  RESULTS
  There were no serious toxic effects in this study. Significant differences were seen in the cumulative overall 5-year survival (HAIC group, 84.1%; non-HAIC group, 65.2%; p=0.0369). The cumulative 5-year liver metastasis-free rate was 92.7% in the HAIC group and 78.6% in the non-HAIC group (p=0.0649). In cases of distal lymph node metastasis, a risk factor for liver metastasis, the cumulative 5-year liver metastasis-free rate in the HAIC group (91.7%) was significantly higher than that in the non-HAIC group (58.6%; p=0.0268).
  
  
  CONCLUSIONS
  HAIC effectively prevents metachronous liver metastasis, especially in patients with pre-existing distal lymph node metastases, and improves the prognosis of advanced colorectal cancer.
authors.affiliation: Second Department of Surgery, Yokohama City University, School of Medicine, Yokohama, Japan. otakun@ra2.so-net.ne.jp
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Ota
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shimada
authors.forename: Hidenobu
authors.initials: H
authors.lastname: Masui
authors.forename: Kuniya
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shigeki
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Ichikawa
authors.forename: Shinji
authors.initials: S
authors.lastname: Togo
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Ike
authors.forename: Shigeo
authors.initials: S
authors.lastname: Oki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage*; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage*; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000401:mortality / Q000517:prevention & control* / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015642:Radiology, Interventional
chemical_list: D000964:Antimetabolites, Antineoplastic; D005472:Fluorouracil