Regional Chemotherapy for Liver Metastases of Colorectal Cancer Shows Varied Perfusion Patterns

Continuous chemotherapy was administered to 82 patients through the hepatic artery via Infusaid pumps to treat liver metastases of colorectal cancer. The study aimed to assess the primary status and evaluate the therapy's success by conducting arterial angiocomputed tomographies (AACTs) immediately after pump implantation and every 3 months thereafter. Findings indicated that 70% of the patients had both liver lobes homogeneously perfused, 24% showed distinct inhomogeneities, and 6% had selective perfusion of either the left or right hepatic lobe. In cases of selective perfusion, only the perfused liver regions exhibited stable disease or regression of the metastases, whereas the nonperfused regions saw progression. At the 3-month follow-up, 50-57% of the patients maintained homogeneous hepatic perfusion, while 26-36% showed inhomogeneities, and 12 patients had incomplete perfusion. The study found no association between the perfusion patterns of the metastases or prechemotherapeutic liver involvement and the response of the metastases to regional chemotherapy. It concluded that liver perfusion should be monitored both intraoperatively or directly postoperatively and during therapy to optimize treatment outcomes.