Preoperative hepatic and regional arterial infusion chemotherapy in the prevention of liver metastasis after colorectai cancer surgery / 中华普通外科杂志

ABSTRACT

Objective To investigate the safety of preoperative hepatic and regional arterial infusion chemotherapy in the prevention of liver metastasis and improving survival after curative colorectal cancer resection.Methods Patients admitted from 2001 to 2007 with Stage Ⅱ or Stage Ⅲ colorectal cancer were randomly assigned to receive preoperative hepatic and regional arterial infusion chemotherapy (PHRAIC group,n=256)or surgery alone(control group,n=253).Toxity of liver,hematology,immunology and post-operative complication of PHRAIC and the control were evaluated.Results Grade Ⅲ hepatic toxity,leukemia,anemia and platelet decrease in PHRAIC group was 3.1%(8/256),5.5% (14/256),7.4%(19/256)and 6.6%(17/256).There were no grade Ⅳ toxities,and all the patients in PHRAIC group received surgery.Morbidity rate in PHRAIC and the control group was 9.8%(25/256)vs 8.3%(21/253)(X2=1.86,P＞0.05).All patients were followed up,with mean follow up of 42±14 months until Oct 30.2007.For stage Ⅲ patients,5-year overall survival and liver metastasis rate were 81.0% in PHRAIc group vs.60.4% in control group(X2=5.15,P＜0.05)and 18.9%(28/148)vs 27.3%(41/150)(X2=5.41,P＜0.05),respectively.Conclusion Preoperative hepatic and regional arterial infusion chemotherapy 7 days before surgery was safe and could reduce liver metastasis and improve survival rate in patients with Stage Ⅲ colorectal cancer.