[Treatment of liver metastases from colorectal cancer--major hepatic resection and continuous hepatic arterial infusion chemotherapy].

From April 1983 to April 1989, 123 cases of liver metastases from colorectal cancer were treated. Forty-three cases underwent hepatic resection. Forty had 5-FU, MMC, and ADM infusion chemotherapy through arterial catheter (FAM i.A.). The remaining had other treatment. In this study, 43 cases of hepatic resection and 32 out of 40 cases of FAM i.A. were evaluated. Thirty-nine of the 43 had major hepatic resection with regional lymph nodes dissection and 4 had partial hepatectomy. Regional lymph-nodes metastases were seen in 5 out of 39 dissected (12.8%). Small liver metastases which could not be diagnosed before or at surgery, were existed in 4 of 15 multiple liver metastases (26.7%). Three-year survival rates, calculates by Kaplan-Meier's method, were 53.5% in all, 57.4% in the solitary, and 42.8% in the multiple metastases. Three-year survival rates of the recurrences were 55% in the extra-hepatic and 24.5% in the hepatic recurrences. FAM i.A. was completed in 32 unresectable liver metastases. Responses of the FAM i.A. were observed in 21/32 (65.6%). Fifty percent survival rates were 11.7 months in all and 22.2 months in 13 cases without extra-hepatic lesions. Considering risk factors (multiple or large solitary metastases, unrecognized small liver metastases, lymph nodes metastases), major anatomic hepatectomy with lymph nodes dissection may be the treatment of choice for liver metastases from colorectal cancer. FAM i.A. had a good local response.