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Abstract:

Between May 2005 and March 2007, catheter-port systems were placed in 20 pts for continuous hepatic artery infusion chemotherapy in the treatment of unresectable colorectal liver metastases. Carboplatin (or oxaliplatin) plus 5-fluorouracil and systemic leucovorin were administered. No complications occurred during the implantation procedures. The mean number of intrahepatic chemotherapy cycles per patient was 10 (4-25). The mean follow-up period was 412 (100-853) days. During the follow-up period, complications occurred in 9 patients (45%), but surgical or interventional radiological correction was successful in all but one case. At present, 14 patients are alive within 4 and 41 months and continue to receive intraarterial chemotherapy, while 6 patients died in 5 to 21 months from tumor progression. The common 1 -year survival is 90% (18 patients). Percutaneous implantation is potentially effective treatment for patients with CLM.

 

Reference 

 

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9.     Hildebrandt B., Pech M., Nicolaou A. et al. Interventionally implanted port catheter systems for hepatic arterial infusion of chemotherapy in patients with colorectal livermetastases: A phase II-study and historical comparisonwith the surgical approach. BMC Cancer. 2007; 24 (7): 69.

 

 

10.   Allen P., Nissan A., Picon A. et al. Technical complications and durability of hepatic artery infusion pumpsfor unresectable colorectal liver metastases. An institutional experience of 544 consecutive cases. J. Am.Coll. Surg. 2005; 201 (1): 57-65.

 

 

11.   Zhu A., Liu L., Piao D. et al. Liver regional continuouschemotherapy: Use of femoral or subclavian artery for percutaneous implantation of catheter-port systems.World.J. Gastroenterol. 2004; 10 (11): 1659-1662.

 

 

12.   Tajima T., Yoshimitsu K., Kuroiwa T. et al. Percutaneous femoral catheter placement for long-term chemotherapy infusions: Preliminary technical results. Am. J.  Roentgenol. 2005; 184 (3): 906-914.IduchiT., Inaba Y., Arai Y. et al. Radiologic removal andreplacement of port-catheter system for hepatic arterial infusion chemotherapy. Am. J. Roentgenol. 2006;187 (6): 1579-1584.

 

 

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15.   Grosso M., Zanon C., Mancini A. et al. Percutaneous implantation of a catheter with subcutaneous reservoir for intraarterial regional chemotherapy :Technique and preliminary results. Cardiovasc. Intervent. Radiol. 2000; 23 (3): 202-210.

 

 

16.   Oi H., Kishimoto H., Matsushita M. et al. Percutaneous implantation of hepatic artery infusion reservoir by sonographically guided left subclavian artery puncture. Am.J. Roentgenol. 1996; 166 (4): 821-822.

 

 

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18.   Proietti S., De BaereT., Bessoud B. et al. Intervetionalmenagement of gastroduodenal lesions complicating intra-arterial hepatic chemotherapy. Eur. Radiol. 2007;17 (8): 2160-2165.

 

 

Abstract:

Purpose. Was to evaluate possibilities of FDCTA as a method of colorectal liver metastases (CLM) detection and differentional diagnostics.

Materials and methods. FD-CT-A was performed to examine 41 patients. Patients with lobe CLM (n =15) were included into the 1-st group. Purpose was to exclude metastatic lesions of contralateral lobe before surgical treatment. Patients with bilobar metastatic spread (n = 26) were included into the 2-nd group. Purpose was to detect metastases before and during regional therapy. Scanning was performed on the hybryde angiographic system Innova-4100 «GЕ Нealthcare, USA» with 5 sec scanning time, fov 23 × 23 cm, delay from 10 to 22 sec during hepatic arteriography 15–40 ml Ultravist-370 «Bayer Schering Pharma, Germany» with rate 2–4 ml/sec.

Results. In the first group 40 CLM were detected. The number of metastases in each patient ranged from 1 to 12 (mean – 3). The size of metastases ranged from 9,1 mm to 150,0 mm (mean – 36,7 mm, median – 30,2 mm). 14 of all CLM (35%) were 20 mm and less. Right hemyhepatectomy was provided for 6 patients, left hemyhepatectomy – for one. In the second group 282 CLM were detected. The number of metastases in each patient ranged from 2 to 31 (mean – 11). The size of metastases ranged from 3,2 mm to 81,0 mm (mean – 17,4 mm, median – 12,7 mm). 209 of all CLM (74%) were equal or smaller then 20 mm in diameter.

Conclusion. FD-CT-A is the perspective method for detection and differentional diagnostics of CLM.
 

 

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