The role of hepatic artery ligation and dearterialization with infusion chemotherapy in advanced malignancies in the liver.

Because of limited benefits derived with the use of systemic chemotherapy, 15 patients with metastatic malignancy of the liver or hepatoma were treated by hepatic artery ligation (6) or dearterialization (9) and regional infusion chemotherapy. There were two postoperative deaths and three patients required surgical drainage of hepatic tumor liquefaction necrosis. The median survival was 14 months with two patients still living. The longest survivors were those patients with visceral leiomyosarcoma or carcinoid tumor. Five of the patients had failed to respond to previous chemotherapy, all showed a favorable response to this therapy. Rigid criteria for proper case selection have been developed which should reduce the operative mortality. Hepatic artery ligation is a therapeutic modality that can be of benefit to patients for whom no other satisfactory treatment is available.