TY - JOUR
T1 - Hepatic arterial infusion after curative resection of colorectal cancer metastases
T2 - A meta-analysis of prospective clinical trials
AU - Clancy, Thomas E.
AU - Dixon, Elijah
AU - Perlis, Roy
AU - Sutherland, Francis R.
AU - Zinner, Michael J.
PY - 2005/2/1
Y1 - 2005/2/1
N2 - The use of hepatic arterial infusion (HAI) for the delivery of chemotherapeutic agents to treat residual microscopic disease after curative hepatic resection for colorectal cancer metastases remains controversial. In recent years, a number of studies examining adjuvant HAI have shown conflicting results. A meta-analysis of prospective clinical trials was performed to determine if adjuvant HAI confers a survival benefit in this setting. Two reviewers independently performed a literature search of MEDLINE, PubMed, EMBASE, the Cochrane library, and the Cochrane Clinical Trials Registry. Prospective clinical trials comparing hepatic arterial chemotherapy after curative hepatic resection for colorectal cancer metastases against a control arm were included. Non-English-language publications were excluded. The outcome measure was survival difference at 1 and 2 years after surgery. Seven studies met the inclusion criteria, and all except one were randomized trials. The survival difference in months (positive values favoring the treatment arm) was 1.8 at 1 year (95% confidence interval, -4.9, 8.5) and 9.6 at 2 years (95% confidence interval, -2.2, 21.4). Neither was statistically significant (at 2 years, P = 0.11). Based on these findings, routine adjuvant HAI after curative resection for colorectal cancer of the liver cannot be recommended. However, given the trend toward a survival benefit at 2 years, further study is recommended.
AB - The use of hepatic arterial infusion (HAI) for the delivery of chemotherapeutic agents to treat residual microscopic disease after curative hepatic resection for colorectal cancer metastases remains controversial. In recent years, a number of studies examining adjuvant HAI have shown conflicting results. A meta-analysis of prospective clinical trials was performed to determine if adjuvant HAI confers a survival benefit in this setting. Two reviewers independently performed a literature search of MEDLINE, PubMed, EMBASE, the Cochrane library, and the Cochrane Clinical Trials Registry. Prospective clinical trials comparing hepatic arterial chemotherapy after curative hepatic resection for colorectal cancer metastases against a control arm were included. Non-English-language publications were excluded. The outcome measure was survival difference at 1 and 2 years after surgery. Seven studies met the inclusion criteria, and all except one were randomized trials. The survival difference in months (positive values favoring the treatment arm) was 1.8 at 1 year (95% confidence interval, -4.9, 8.5) and 9.6 at 2 years (95% confidence interval, -2.2, 21.4). Neither was statistically significant (at 2 years, P = 0.11). Based on these findings, routine adjuvant HAI after curative resection for colorectal cancer of the liver cannot be recommended. However, given the trend toward a survival benefit at 2 years, further study is recommended.
KW - Colorectal cancer
KW - Colorectal metastases
KW - Hepatic artery chemotherapy
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=13444254180&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=13444254180&partnerID=8YFLogxK
U2 - 10.1016/j.gassur.2004.07.004
DO - 10.1016/j.gassur.2004.07.004
M3 - Article
C2 - 15694815
AN - SCOPUS:13444254180
SN - 1091-255X
VL - 9
SP - 198
EP - 206
JO - Journal of Gastrointestinal Surgery
JF - Journal of Gastrointestinal Surgery
IS - 2
ER -