Hepatic artery chemoembolization.

Chemoembolization is a technique that can deliver high concentrations of therapeutic agents directly to the liver for prolonged periods. Considerable experience has been gained in the treatment of hepatocellular carcinoma, where it appears to be a safe procedure that provides survival advantage over conservative therapy. There is much less experience in the treatment of hepatic metastases. Patients with carcinoid, pancreatic islet cell tumor, and sarcoma metastatic to the liver do appear to benefit from chemoembolization. Efficacy in other groups, such as patients with colorectal cancer metastatic to the liver, is less well established, but a recently initiated multicenter trial may resolve this issue.