[Microwave coagulation therapy for liver recurrence after resection of metastatic colorectal cancer--comparison with re-hepatectomy].

One hundred and fifty-three patients with liver metastases from colorectal cancer underwent hepatectomy from 1979 to 1998. Recurrence in the residual liver occurred in 71 of the 129 patients with curative B resection, and re-hepatectomy has been done in 21 of these 71 patients since 1984. The 5-year survival rate is 37.0%. MCT has been performed in ten of these 71 patients who could not undergo re-hepatectomy and one patient received both therapies. The 3-year survival rate is 66.7%, which is statistically better than that of 35 patients who could not undergo re-hepatectomy before we started MCT (3-year survival rate of 20.0%). Re-hepatectomy is quite effective for recurrent liver remetastasis after hepatectomy, and MCT is probably of similar value.

[A case report: successful resection of advanced intrahepatic cholangiocarcinoma responding to preoperative hepatic artery infusion of 5-FU].

A patient with advanced intrahepatic cholangiocarcinoma had a tumor embolus in the right main branch of the portal vein and lymph node metastases. Hepatic arterial infusion (HAI) therapy with 5-FU (1 g/day) was given as a continuous infusion for 6 days. The treatment was repeated after a one-week interval. As a result the tumor diameter decreased by half, and the tumor embolus contracted. Cytoreductive surgery was then performed. The patient has been disease-free for over 9 months postoperatively with adjuvant HAI with 5-FU. We consider preoperative HAI with 5-FU (two courses of 1 g/day x 6 days) is both safe and effective.

[Efficacy of combination therapy (hepatectomy and prophylactic arterial chemoinfusion) for liver metastases of colorectal cancer].

From 1979 to 1997, 146 patients had hepatectomy for metastases of colorectal cancer (curative B: 122; curative C: 24). We categorized the severity of liver metastases as follows, H1: one lobe; H2: bilateral but less than five, and H3: bilateral with five or more lesions. In H1 and H2 patients, we compared the survival rate after resection alone (including repeat hepatectomy) with that after combination therapy (resection and prophylactic arterial chemoinfusion of 12-24 g of 5-FU). In H1 patients, the 3-year survival rate of the resected group (n = 74) and combination group (n = 6) was 47.2 and 53.3, respectively. In H2 patients, the resected group (n = 16) and combination group (n = 7) had survival rates of 34.5 and 100%, respectively. In H1 cases, the 3-year recurrence rate in the remnant liver was 63.4 versus 16.7% and in H2 cases it was 58.0 versus 0%. H3 patients received one week of continuous prophylactic arterial chemoinfusion [total dose of 5-FU = 6 g]. All four patients in the H3 combination group are alive at 20, 13, 13, and 12 months after resection, while the median survival of the resection only group (n = 4) was 12.5 months. We suggest that our combination therapy may be applicable to all patients with liver metastases of colorectal cancer.