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Safety and feasibility of establishing an adjuvant hepatic artery infusion program.

Safety and feasibility of establishing an adjuvant hepatic artery infusion program.

Authors :
Janczewski LM
Joung RH
Borhani AA
Lewandowski RJ
Velichko YS
Mulcahy MF
Mahalingam D
Law J
Bowman C
Keswani RN
Poylin VY
Bentrem DJ
Merkow RP
Source :
HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2024 May; Vol. 26 (5), pp. 656-663. Date of Electronic Publication: 2023 Dec 13.
Publication Year :
2024

Abstract

Background: Hepatic artery infusion (HAI) is less frequently used in the adjuvant setting for resectable colorectal liver metastasis (CRLM) due to concerns regarding toxicity. Our objective was to evaluate the safety and feasibility of establishing an adjuvant HAI program.<br />Methods: Patients who underwent HAI pump placement between January 2019 and February 2023 for CRLM were identified. Complications and HAI delivery were compared between patients who received HAI in the unresectable and adjuvant settings.<br />Results: Of 51 patients, 23 received HAI for unresectable CRLM and 28 in the adjuvant setting. Patients with unresectable CRLM more commonly had bilobar disease (n = 23/23 vs n = 18/28, p < 0.01) and more preoperative liver metastases (median 10 [IQR 6-15] vs 4 [IQR 3-7], p < 0.01). Biliary sclerosis was the most common complication (n = 2/23 vs n = 4/28); however, there were no differences in postoperative or HAI-specific complications. In the most recent two years, 0 patients in the unresectable group vs 2 patients in the adjuvant group developed biliary sclerosis. All patients were initiated on HAI with no difference in treatment times or dose reductions.<br />Conclusion: Adjuvant HAI is safe and feasible for patients with resectable CRLM. HAI programs can carefully consider including patients with resectable CRLM if managed by an experienced multidisciplinary team with quality assurance controls in place.<br /> (Copyright © 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.)

Details

Language :
English
ISSN :
1477-2574
Volume :
26
Issue :
5
Database :
MEDLINE
Journal :
HPB : the official journal of the International Hepato Pancreato Biliary Association
Publication Type :
Academic Journal
Accession number :
38383208
Full Text :
https://doi.org/10.1016/j.hpb.2023.12.006