Original Articles
Copyright ©The Author(s) 1998. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 15, 1998; 4(Suppl2): 35-37
Published online Oct 15, 1998. doi: 10.3748/wjg.v4.iSuppl2.35
Value of selective chemoembolization in the treatment of hepatic metastases in colorectal carcinoma
Xiao-Wei Xiao
Xiao-Wei Xiao, Department of Gastroenterology, Central Hospital in JiangHan Oil Field, Qianjiang 433124, Hubei Province, China
Xiao-Wei Xiao, male, born on 1964-10-01 in Xiaogan City, Hubei province, graduated from Hubei Medical University, specialized in research and treatment of gastroenterol tumors, having 24 papers and 4 books published.
Author contributions: The author solely contributed to the work.
Correspondence to: Dr. Xiao-Wei Xiao, Department of Gastroenterology, Central Hospital in JiangHan Oil Field, No.3 Ankang Road, Qianjiang 433124, Hubei Province, China
Telephone: +86-728-6504533
Received: April 8, 1998
Revised: May 12, 1998
Accepted: June 9, 1998
Published online: October 15, 1998
Abstract

AIM: To explore the therapeutic effect of chemoembolization in hepatic metastases in colorectal carcinoma.

METHODS: Forty patients underwent chemoembolization of metastatic liver lesion from colorectal carcinoma. Selective angiography of the hepatic a rtery was performed to identify the feeding vessels of the metastatic lesion. The injected chemoemulsum consisted of 100 mg 5-fluorouracil, 10 mg mit omycin C and 10 mL lipiodol ultra fluid in a total volume of 30 mL. Gel foam embolization then followed until stagnation of blood flow was achieved. Patients were evaluated for response, over all survival, and side effects.

RESULTS: Overall median survival time from date of first chemoembolization was ten mo. Median survival time of cirrhotic patients with class A and B by Child-Pugh classification was 24 and 3 mo, respectively. The difference was significant, (P < 0.01). Patients with metastatic disease confined to the liver did better than those who also had extrahepatic disease, with median survivals of 14 and 3 mo, respectively (P < 0.02). There were significant differences in that median survival of patients with hypervascular metastases was longer than that of patients with hypovascular metastases. The most common side effects were transient fever, abdominal pain and fatigue. Three patients died within one mo from the procedure.

CONCLUSION: The therapeutic effect of systemic chemotherapy in hepatic metastases of large intestinal carcinoma was not satisfactory and there were more side effects, whereas the therapeutic effect of selective chemoembolization was promising and there were less side effects. Selective chemoembolization may be an effective first-line therapy in hepatic metastases of large intestinal carcinoma.

Keywords: Colonic neoplasms; Rectal neoplasms; Liver neoplasms/drug therapy; Liver neoplasms/secondary; Chemoembolization, therapeutic; Fluorouracil/therapeutic use; Mitomycins/therapeutic use