Ambiru S, Miyazaki M, Ito H, Kaiho T, Ando K, Hayashi S, Nakajima N
First Department of Surgery, Chiba University School of Medicine, Japan.
Nihon Geka Gakkai Zasshi. 1995 Mar;96(3):145-52.
Fifty-five patients with hepatic metastasis from colorectal cancer underwent curative hepatic resection. Postoperative intraportal infusion of 5-fluorouracil (500mg per day) for 14 days from 21 postoperative days (POD) and lipiodol-aclarubicin (40mg) at 35 POD was carried out in twenty-eight patients for reducing the recurrence in the remnant liver and improving the prognosis. Twenty-seven patients had hepatectomy alone as controls. Intraportal infusion chemotherapy did not induce any hepatotoxicity and hematologic severe abnormalities. The cumulative survival rates for the infusion group and the control group, respectively, were 89.3% and 63.0% at 1 year; 55.2% and 43.3% at 2 year; 27.0% and 27.5% at 3 year. The survival rate for the infusion group was significantly higher than that for the control group at 1 year (p < 0.05). No difference of the recurrent rate in the remnant liver was found between the two groups. It is suggested that intraportal infusion chemotherapy after curative hepatic resection for colorectal liver metastasis might improve survival rate at the early postoperative period. Intraportal infusion chemotherapy could be an effective adjuvant therapy especially in the patients with bilateral and multiple hepatic metastasis.
55例结直肠癌肝转移患者接受了根治性肝切除术。28例患者在术后第21天开始进行为期14天的门静脉内输注5-氟尿嘧啶（每天500mg），并在术后第35天进行碘油-阿克拉霉素（40mg）灌注，以降低残肝复发率并改善预后。27例患者仅行肝切除术作为对照。门静脉内灌注化疗未引起任何肝毒性和严重血液学异常。输注组和对照组的1年累积生存率分别为89.3%和63.0%；2年时分别为55.2%和43.3%；3年时分别为27.0%和27.5%。输注组1年生存率显著高于对照组（p<0.05）。两组间残肝复发率无差异。提示结直肠癌肝转移根治性肝切除术后门静脉内灌注化疗可能提高术后早期生存率。门静脉内灌注化疗可能是一种有效的辅助治疗方法，尤其适用于双侧和多发肝转移患者。
