Survival following self-administered chemotherapy for liver metastases

Fifty-three patients with unresectable liver metastases from colorectal cancer either self-administered or had a family member administer 5-fluorouracil (5-FU) (12 mg/kg/day for 5 days in alternate weeks) through intraoperatively placed hepatic artery and/or portal vein catheters. Twenty percent had failed previous systemic chemotherapy. Seventeen who were symptomatic received additional radiotherapy. Metastasis was confined to the liver in 38, while 15 also had extrahepatic metastases. Median survival for those with hepatic metastases only was 21 months from diagnosis and 16 months from catheter insertion. There are three long-term survivors in this group, alive 58, 69, and 86 months, respectively, from diagnosis. Median survival for those with hepatic and extrahepatic metastases was 10 months from diagnosis and 6 months from catheter insertion. No patient in this group has survived long term. Catheter-related complications occurred in 20% of the patients; none were fatal. Drug toxicities were minor. Self-administered chemotherapy is a safe, effective, and simple method of achieving prolonged survival in patients with unresectable hepatic metastasis from colorectal cancer.