title: Hepatic artery infusional chemotherapy in patients with unresectable colorectal liver metastases and extrahepatic disease.
abstract: OBJECTIVE
  Hepatic arterial infusional (HAI) chemotherapy combined with systemic chemotherapy is effective palliative therapy for unresectable colorectal cancer liver metastases (CRLM). Some patients considered for HAI have evidence of minimal extrahepatic disease (EHD), and the role of HAI in these situations is unknown.
  
  
  METHODS
  All patients with unresectable CRLM treated with HAI and systemic chemotherapy from 2000 to 2009 were included. Survival of patients who were ultimately proven to have low-volume EHD was compared to those without EHD.
  
  
  RESULTS
  Three hundred seventy-three patients were included in this study. Seventy-nine percent of patients were previously treated with chemotherapy. One hundred forty-five patients (39%) ultimately proved to have EHD. Median overall survival from HAI pump placement in patients without EHD was 32 months compared to 16 months for patients with EHD, P < 0.001. Median overall survival from HAI pump placement in patients with a single site of EHD was 18 months compared to 9 months for those with multiple sites of EHD, P = 0.01.
  
  
  CONCLUSIONS
  In this study of heavily pre-treated patients, overall survival was favorable in patients who proved to have EHD at one site.
authors: Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. john.ammori@uhhospitals.org
authors: John B
authors: JB
authors: Ammori
authors: Michael I
authors: MI
authors: D'Angelica
authors: Yuman
authors: Y
authors: Fong
authors: Andrea
authors: A
authors: Cercek
authors: Ronald P
authors: RP
authors: Dematteo
authors: Peter J
authors: PJ
authors: Allen
authors: T Peter
authors: TP
authors: Kingham
authors: Philip B
authors: PB
authors: Paty
authors: William R
authors: WR
authors: Jarnagin
authors: Nancy E
authors: NE
authors: Kemeny
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005500:Follow-Up Studies; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000503:physiopathology / Q000556:secondary; D008875:Middle Aged; D011446:Prospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome; D055815:Young Adult