Isolated hyperthermic liver perfusion with chemotherapy for liver malignancy

Area of Science:

• Oncology
• Surgical Oncology
• Experimental Therapeutics

Background:

• Unresectable liver tumors present a significant therapeutic challenge.
• Isolated regional perfusion offers a method for targeted drug delivery to the liver.

Purpose of the Study:

• To evaluate the feasibility and efficacy of isolated regional perfusion with hyperthermia and cytotoxic drugs for unresectable liver tumors.
• To assess the toxicity and survival outcomes associated with this treatment modality.

Main Methods:

• An open study involving 29 patients with various unresectable liver tumors.
• Isolated liver perfusion using a pump oxygenator with melphalan and cis-platinum at 40°C.
• Porto-caval shunting and dual venous drainage were employed.

Main Results:

• Four patients (with >50% liver involvement) died within 30 days due to multiple organ failure.
• All surviving patients experienced reversible hepato- and renal toxicity.
• Partial tumor regression was observed in 20% of patients, with five surviving over three years.

Conclusions:

• Hyperthermic isolated liver perfusion is a feasible treatment for unresectable liver tumors.
• A significant risk of multiple organ failure exists in patients with massive liver tumor burden.
• The treatment shows potential for tumor regression and long-term survival in select patients.