Results of resection and adjuvant therapy of liver metastases of primary colorectal tumors--a review of the literature

• Published in: Zentralblatt für Chirurgie Vol. 120; no. 10; p. 769
• Main Authors: Lorenz, M, Staib-Sebler, E, Rossion, I, Koch, B, Gog, C, Encke, A
• Format: Journal Article
• Language: German
• Published: Germany 1995
• Subjects: Antibodies, Monoclonal - administration & dosage; Antibodies, Monoclonal - adverse effects; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Chemotherapy, Adjuvant; Chemotherapy, Cancer, Regional Perfusion; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - mortality; Colorectal Neoplasms - surgery; Combined Modality Therapy; Disease-Free Survival; Floxuridine - administration & dosage; Floxuridine - adverse effects; Fluorouracil - administration & dosage; Fluorouracil - adverse effects; Follow-Up Studies; Hepatectomy; Humans; Immunotherapy, Active; Infusions, Intra-Arterial; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Treatment Outcome
• ISSN: 0044-409X

Natural history of patients with colorectal liver metastases is not significantly changed even by curative resection. The majority unfortunately relapse. The results of adjuvant treatment after resection were evaluated by analysis of 17 publications as well as by own data (60 patients). 340 patients were either treated by intraarterial (n = 201), systemic (n = 82), intraportal (n = 29) or intraperitoneal (n = 28) chemoinfusion (5-Fluorouracil or Floxuridine). An alternative approach was the treatment with specific immunotherapy using tumor vaccination (n = 35) or monoclonal antibodies (n = 20). Morbidity of adjuvant treatment includes local (chemical hepatitis, biliary sclerosis) and systemic (diarrhea, stomatitis) side effects. Technical complications could reach a level of up to 50% in case of local administration. With exception of 6 studies no comparison with a resection only group was performed. Despite postulated increase of survival and recurrence free time with historical controls the results of current ongoing studies are needed before general use of adjuvant treatment can be recommended.