Regional treatment of colorectal liver metastasis

Compared to systemic chemotherapy, intraarterial administration of tumoricidal agents with or without systemic chemotherapy in the treatment of nonresectable metastatic colorectal cancer is associated with superior response rate. The time-to-hepatic progression is also increased but the effect on overall survival is variable. When combined with other treatment modalities the number of patients who benefit from the treatment increases. In a subgroup of patients with resectable disease, hepatic artery infusion of chemotherapy as adjuvant therapy may be beneficial. Progression of the disease, hepatic and systemic toxicity, and complexity of the surgical aspects of the treatment limit the routine use of this treatment modality.