Liver perfusion chemotherapy via both the hepatic artery and portal vein to prevent hepatic metastasis after extended pancreatectomy for adenocarcinoma of the pancreas

Am J Surg. 1994 Oct;168(4):361-4. doi: 10.1016/s0002-9610(05)80167-9.

Abstract

Since hepatic metastasis is a common cause of treatment failure after curative pancreatectomy for adenocarcinoma of the pancreas, we developed a new method of postoperative hepatic perfusion chemotherapy via both the hepatic artery and portal vein. The present study was conducted to determine if this method decreases the hepatic recurrence and improves the survival rate. Following extended pancreatectomy with wide lymphatic and connective tissue clearance for pancreatic cancer, one catheter was placed in the hepatic artery and one in the portal vein. Immediately after surgery, 5-fluorouracil (125 mg/d) was continuously infused via these two routes simultaneously for 28 to 35 days. There were no treatment-related complications in the 20 patients who survived surgery. The 3-year survival rate was 54%, and the cumulative rate of death from hepatic metastasis was 8%. These figures were significantly better than those of our historical control groups. We conclude that this method should be evaluated in a prospective, randomized controlled study.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / secondary*
  • Adenocarcinoma / therapy*
  • Aged
  • Chemotherapy, Adjuvant
  • Chemotherapy, Cancer, Regional Perfusion / methods*
  • Combined Modality Therapy
  • Female
  • Fluorouracil / administration & dosage*
  • Hepatic Artery
  • Humans
  • Infusions, Intravenous
  • Liver Neoplasms / mortality
  • Liver Neoplasms / secondary*
  • Liver Neoplasms / therapy*
  • Lymph Node Excision*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / epidemiology
  • Pancreatectomy*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / therapy*
  • Portal Vein
  • Postoperative Care
  • Survival Rate
  • Time Factors

Substances

  • Fluorouracil