Abstract
Purpose
To compare retrospectively the safety and efficacy of percutaneous and surgical implantations of port-catheters for intra-arterial hepatic chemotherapy (IAHC).
Materials and Methods
Between January 2004 and December 2008, 126 consecutive patients (mean age 58 years) suffering from liver colorectal metastases were referred for intra-arterial hepatic chemotherapy (IAHC). Port-catheters were percutaneously implanted (P) through femoral access with the patient under conscious sedation when no other surgery was planned or were surgically implanted (S) when laparotomy was performed for another purpose. We report the implantation success rate, primary functionality, functionality after revision, and complications of IAHC.
Results
The success rates of implantation were 97% (n = 65 of 67) for P and 98% (n = 58 of 59) for S. One hundred eleven patients received IAHC in our institution (n = 56P and n = 55S). Primary functionality was the same for P and S (4.80 vs. 4.82 courses), but functionality after revision was significantly higher for P (9.18 vs. 5.95 courses, p = 0.004) than for S. Forty-five complications occurred during 516 courses for P and 28 complications occurred during 331 courses for S. The rates of discontinuation of IAHC linked to complications of the port-catheters were 21% (n = 12 of 56) for P and 34% (n = 19 of 55) for S.
Conclusion
Overall, significantly better functionality and similar complication rates occurred after P versus S port-catheters.
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References
Saltz L, Clarke S, Díaz-Rubio E et al (2008) Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase III study. J Clin Oncol 26:2013–2019
Kabbinavar FF, Hambleton J, Mass RD et al (2005) Combined analysis of efficacy: the addition of bevacizumab to fluorouracil of leucovorin improves survival for patients with metastatic colorectal cancer. J Clin Oncol 23:3706–3712
Hurwitz H, Fehrenbacher L, Novotny W et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350:2335–2342
Giantonio BJ, Catalano PJ, Meropol NJ et al (2007) Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol 25:1539–1544
Herrmann KA, Waggershauser T, Sittek H et al (2000) Liver intraarterial chemotherapy: use of the femoral artery for percutaneous implantation of catheter-port systems. Radiology 215(1):294–299
Arai Y, Takeuchi Y, Inaba Y et al (2007) Interventional techniques for hepatic arterial infusion chemotherapy. Tech Vasc Interv Radiol 10:30–37
Elias D, de Baere T, Sideris L et al (2004) Regional chemotherapeutic techniques for liver tumors: current knowledge and future directions. Surg Clin North Am 84(2):607–625
Ducreux M, Ychou M, Laplanche A et al (2005) Hepatic arterial oxaliplatin infusion plus intravenous chemotherapy in colorectal cancer with inoperable hepatic metastases: a trial of the gastrointestinal group of the Federation Nationale des Centres de Lutte Contre le Cancer. J Clin Oncol 23:4881–4887
Hildebrandt B, Pech M, Nicolaou A et al (2007) Interventionally implanted port catheter systems for hepatic arterial infusion of chemotherapy in patients with colorectal liver metastases: a phase II-study and historical comparison with the surgical approach. BMC Cancer 7:69
Oberfield RA, Sampson E, Heatley GJ (2004) Hepatic artery infusion chemotherapy for metastatic colorectal cancer to the liver at the Lahey Clinic: comparison between two methods of treatment, surgical versus percutaneous catheter placement. Am J Clin Oncol 27(4):376–383
Acknowledgement
The authors of this paper wish to thank Joey Marie Robinson for her generous assistance in editing and preparation of this manuscript.
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Deschamps, F., Elias, D., Goere, D. et al. Intra-Arterial Hepatic Chemotherapy: A Comparison of Percutaneous Versus Surgical Implantation of Port-Catheters. Cardiovasc Intervent Radiol 34, 973–979 (2011). https://doi.org/10.1007/s00270-010-9996-6
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DOI: https://doi.org/10.1007/s00270-010-9996-6