Intra-arterial Chemotherapy of Liver Metastases

The liver is the first and most frequent site of metastasis of gastroenteric cancer; in 10% of cases such pathology is already present at the time of diagnosis of the primary neoplasm. Metachronous metastases occur within 5 years in 20% of patients. The average survival in the case of untreated liver metastases from large bowel cancer is 6–8 months; 30%–35% of such patients are alive after 6 months and only 15%–18% at 1 year [1,5]. The therapy of liver metastases is based on surgical resection, systemic chemotherapy, and radiotherapy, but response rates are not good. Surgery is indicated only when the liver presents a single metastasis or multiple metastases confined to one lobe; this is the case in 20%–25% of patients, and no more than 5%– 10% cases are actually operable. Chemotherapy is indicated in all other patients, and because systemic treatment is ineffective many groups throughout the world have been using locoregional intra-arterial therapy [6, 9].