Intrahepatic therapy for resected hepatic metastases from colorectal carcinoma

A significant number of patients with colorectal cancer will present with hepatic metastases as their only site of metastatic disease. Surgical resection in patients with a limited number of metastases will lead to long-term survival in up to one-third. However, following surgery, many of these patients will relapse within the liver, and many will develop extrahepatic metastases. The use of hepatic artery infusion alternating with systemic therapy has proven to reduce the risk of recurrent disease and improve survival. Impressive response rates have been achieved with the combination of oxaliplatin and fluorouracil (5-FU) in patients with metastatic colorectal carcinoma. In one trial, this combination resulted in significant tumor shrinkage allowing resection of previously unresectable hepatic metastases. Given the promising activity of oxaliplatin (Eloxatin), 5-FU, and leucovorin, a trial is now in development to assess the efficacy of this combination when used together with hepatic artery infusion.