Hyperthermic isolated liver perfusion for unresectable liver cancers: pilot study.

Isolated hepatic perfusion (IHP) is a recently reconsidered locoregional approach for unresectable primary or metastatic cancer and encouraging results have been achieved from its clinical application. Ten patients underwent hyperthermic IHP with melphalan. There was no intraoperative mortality. In the postoperative period two patients died due to multi-organ failure. Four patients had significant but transient hepatic toxicity. In 8 assessable patients, the overall response rate was 63%. We observed objective tumor regression in a significant percentage of patients refractory to standard treatments. Locoregional toxicity was significant, which underscores the need for a more accurate preoperative evaluation of hepatic function.

Hypoxic antiblastic stop-flow perfusion: clinical outcome and pharmacokinetic findings.

Stop-flow perfusion (SFP) is a recently implemented locoregional treatment based on the vascular isolation of the tumor bearing body district through a radiointerventistic technique. SFP is currently under investigation as a palliative therapeutic option for patients with locally advanced tumors. This paper reports on the results of our prospective study of limb and pelvic SFP. Thirty-seven patients were treated with SFP. No postoperative deaths occurred. Locoregional and systemic toxicity were observed after 22 and 31 treatments, respectively; complete and partial response after 3 (6%) and 24 (51%) SFPs, respectively. The pharmacokinetic study showed that pelvic SFP was associated with a leakage rate higher than femoral SFP (38% vs 28%). In conclusion, SFP is a feasible procedure. Toxicity and tumor response rates strictly depend upon drug leakage control.