title: Hepatic arterial infusion pump chemotherapy in the management of colorectal liver metastases: expert consensus statement.
abstract: Despite significant improvements in systemic therapy for patients with colorectal liver metastases (crlms), response rates in the first-line setting are not optimal, and response rates in the second-line setting remain disappointing. Hepatic arterial infusion pump (haip) chemotherapy has been extensively studied in patients with crlms, but it remains infrequently used. We convened an expert panel to discuss the role of haip in the contemporary management of patients with crlm. Using a consensus process, we developed these statements: haip chemotherapy should be given in combination with systemic chemotherapy.haip chemotherapy should be offered in the context of a multidisciplinary program that includes expertise in hepatobiliary surgery, medical oncology, interventional radiology, nursing, and nuclear medicine.haip chemotherapy in combination with systemic therapy should be considered in patients with unresectable crlms who have progressed on first-line systemic treatment. In addition, haip chemotherapy is acceptable as first-line treatment in patients with unresectable colorectal liver metastases.haip chemotherapy is not recommended in the setting of extrahepatic disease outside the context of a clinical trial.haip chemotherapy in combination with systemic therapy is an option for select patients with resected colorectal liver metastases. These consensus statements provide a framework that clinicians who treat patients with crlm can use when considering treatment with haip.
authors: Ontario: Departments of Surgery (Karanicolas, Wei, Cleary), Medicine (Chan, Ko), and Medical Imaging (Dey), University of Toronto, Toronto; Departments of Surgery (Karanicolas), Medicine (Chan, Ko), and Medical Imaging (Dey), Sunnybrook Health Sciences Centre, Toronto; Departments of Medicine (Chen) and Surgery (Wei, Cleary), University Health Network, Toronto; Department of Medicine (Asmis), University of Ottawa, Ottawa.
authors: P J
authors: PJ
authors: Karanicolas
authors: Quebec: Department of Surgery (Metrakos, Zogopoulos), McGill University, Montreal.
authors: P
authors: P
authors: Metrakos
authors: Ontario: Departments of Surgery (Karanicolas, Wei, Cleary), Medicine (Chan, Ko), and Medical Imaging (Dey), University of Toronto, Toronto; Departments of Surgery (Karanicolas), Medicine (Chan, Ko), and Medical Imaging (Dey), Sunnybrook Health Sciences Centre, Toronto; Departments of Medicine (Chen) and Surgery (Wei, Cleary), University Health Network, Toronto; Department of Medicine (Asmis), University of Ottawa, Ottawa.
authors: K
authors: K
authors: Chan
authors: Ontario: Departments of Surgery (Karanicolas, Wei, Cleary), Medicine (Chan, Ko), and Medical Imaging (Dey), University of Toronto, Toronto; Departments of Surgery (Karanicolas), Medicine (Chan, Ko), and Medical Imaging (Dey), Sunnybrook Health Sciences Centre, Toronto; Departments of Medicine (Chen) and Surgery (Wei, Cleary), University Health Network, Toronto; Department of Medicine (Asmis), University of Ottawa, Ottawa.
authors: T
authors: T
authors: Asmis
authors: Ontario: Departments of Surgery (Karanicolas, Wei, Cleary), Medicine (Chan, Ko), and Medical Imaging (Dey), University of Toronto, Toronto; Departments of Surgery (Karanicolas), Medicine (Chan, Ko), and Medical Imaging (Dey), Sunnybrook Health Sciences Centre, Toronto; Departments of Medicine (Chen) and Surgery (Wei, Cleary), University Health Network, Toronto; Department of Medicine (Asmis), University of Ottawa, Ottawa.
authors: E
authors: E
authors: Chen
authors: New York State: Departments of Surgery (Kingham, Fong, D'Angelica) and Medicine (Kemeny), Memorial Sloan-Kettering Cancer Center, New York, NY, U.S.A.
authors: T P
authors: TP
authors: Kingham
authors: New York State: Departments of Surgery (Kingham, Fong, D'Angelica) and Medicine (Kemeny), Memorial Sloan-Kettering Cancer Center, New York, NY, U.S.A.
authors: N
authors: N
authors: Kemeny
authors: Nova Scotia: Department of Surgery (Porter), Dalhousie University, Halifax.
authors: G
authors: G
authors: Porter
authors: Missouri: Department of Surgery (Fields), Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis.
authors: R C
authors: RC
authors: Fields
authors: Pennsylvania: Department of Surgery (Pingpank), University of Pittsburgh, Pittsburgh.
authors: J
authors: J
authors: Pingpank
authors: Alberta: Departments of Surgery (Dixon) and Medicine (Dowden), University of Calgary, Calgary.
authors: E
authors: E
authors: Dixon
authors: Ontario: Departments of Surgery (Karanicolas, Wei, Cleary), Medicine (Chan, Ko), and Medical Imaging (Dey), University of Toronto, Toronto; Departments of Surgery (Karanicolas), Medicine (Chan, Ko), and Medical Imaging (Dey), Sunnybrook Health Sciences Centre, Toronto; Departments of Medicine (Chen) and Surgery (Wei, Cleary), University Health Network, Toronto; Department of Medicine (Asmis), University of Ottawa, Ottawa.
authors: A
authors: A
authors: Wei
authors: Ontario: Departments of Surgery (Karanicolas, Wei, Cleary), Medicine (Chan, Ko), and Medical Imaging (Dey), University of Toronto, Toronto; Departments of Surgery (Karanicolas), Medicine (Chan, Ko), and Medical Imaging (Dey), Sunnybrook Health Sciences Centre, Toronto; Departments of Medicine (Chen) and Surgery (Wei, Cleary), University Health Network, Toronto; Department of Medicine (Asmis), University of Ottawa, Ottawa.
authors: S
authors: S
authors: Cleary
authors: Quebec: Department of Surgery (Metrakos, Zogopoulos), McGill University, Montreal.
authors: G
authors: G
authors: Zogopoulos
authors: Ontario: Departments of Surgery (Karanicolas, Wei, Cleary), Medicine (Chan, Ko), and Medical Imaging (Dey), University of Toronto, Toronto; Departments of Surgery (Karanicolas), Medicine (Chan, Ko), and Medical Imaging (Dey), Sunnybrook Health Sciences Centre, Toronto; Departments of Medicine (Chen) and Surgery (Wei, Cleary), University Health Network, Toronto; Department of Medicine (Asmis), University of Ottawa, Ottawa.
authors: C
authors: C
authors: Dey
authors: New York State: Departments of Surgery (Kingham, Fong, D'Angelica) and Medicine (Kemeny), Memorial Sloan-Kettering Cancer Center, New York, NY, U.S.A.
authors: M
authors: M
authors: D'Angelica
authors: New York State: Departments of Surgery (Kingham, Fong, D'Angelica) and Medicine (Kemeny), Memorial Sloan-Kettering Cancer Center, New York, NY, U.S.A.
authors: Y
authors: Y
authors: Fong
authors: Alberta: Departments of Surgery (Dixon) and Medicine (Dowden), University of Calgary, Calgary.
authors: S
authors: S
authors: Dowden
authors: Ontario: Departments of Surgery (Karanicolas, Wei, Cleary), Medicine (Chan, Ko), and Medical Imaging (Dey), University of Toronto, Toronto; Departments of Surgery (Karanicolas), Medicine (Chan, Ko), and Medical Imaging (Dey), Sunnybrook Health Sciences Centre, Toronto; Departments of Medicine (Chen) and Surgery (Wei, Cleary), University Health Network, Toronto; Department of Medicine (Asmis), University of Ottawa, Ottawa.
authors: Y J
authors: YJ
authors: Ko
keywords: Colorectal metastases; adjuvant chemotherapy; hepatic arterial infusion pump chemotherapy; intraarterial chemotherapy; liver metastases; unresectable metastases