Hepatic chemoinfusion of 5-FU in metastasis of gastrointestinal cancer and advanced primary hepatocellular carcinoma

: From 1 January 1983 to 1 January 1988, 38 patients were treated for hepatic cancer in the HEINZ-KALK-Hospital. Thirty-one of these had liver metastases due to gastrointestinal cancer and seven had advanced primary hepatocellular cancer. In all patients more than 50% of the liver volume was involved with the tumour or the metastases. Eleven patients with liver metastases of gastrointestinal cancer (excepting colorectal cancer) were treated by intra-arterial hepatic bolus infusion of 750-1000 mg 5-fluorouracil (5-FU) by selective catheterisation of the hepatic or superior mesenteric artery after puncture of the right or left femoral artery. The median survival was 13.4 months. In seven patients with advanced primary hepatocellular carcinoma the same therapeutic regime was used. The median survival was 10 months. In the 21 patients with disseminated metastases of previously resected colorectal cancer a catheter was inserted into the gastro-duodenal artery and connected to a subcutaneously placed port. Brief infusions of 750-1000 mg 5-FU were administered for 14 days with a day interruption and thereafter 2 month interruption. There were few side effects and 80% of the patients continued to work or carry on a normal life. The median survival was 14.4 months. Based on this experience we consider hepatic chemoinfusion with 5-FU in gastrointestinal cancer and advanced primary hepatocellular carcinoma is capable of improving quality of life and possibly expectancy.