Follow-up on a prospective study of continuous hepatic perfusion with implantable pump

Continuous chemotherapy for hepatic metastases secondary to carcinoma of the colon and/or rectum was delivered via implantable pump in 20 patients. This is a follow-up to a preliminary report published in January 1985. Pumps were placed by a single surgeon in a community hospital; there was no mortality and minimal morbidity. Follow-up of these patients revealed a significant long-term complication rate secondary to effects of chemotherapy. Nine patients were alive at the cutoff date of this report; mean follow-up was 16 months. Eleven patients have died following implantation, with a mean survival of 14 months. Statistical analyses demonstrated increased survival rates for those patients whose tumors were poorly differentiated when compared with those with moderately differentiated or well-differentiated tumors. The objective response of liver metastases was overwhelmingly positive, as judged by CT scan and serial CEA levels. The significant rehospitalization rate for complications and the marginal increase in survival, however, have discouraged implantation of the pump at our institution.