Adjuvant hepatic arterial infusion pump chemotherapy after resection of colorectal liver metastases: Results of a safety and feasibility study in the Netherlands Journal Article


Authors: Buisman, F. E.; Grünhagen, D. J.; Homs, M. Y. V.; Grootscholten, C.; Filipe, W. F.; Kemeny, N. E.; Cercek, A.; D’Angelica, M. I.; Donswijk, M. L.; van Doorn, L.; Emmering, J.; Jarnagin, W. R.; Kingham, T. P.; Klompenhouwer, E. G.; Kok, N. F. M.; Kuiper, M. C.; Moelker, A.; Prevoo, W.; Versleijen, M. W. J.; Verhoef, C.; Kuhlmann, K. F. D.; Groot Koerkamp, B.
Article Title: Adjuvant hepatic arterial infusion pump chemotherapy after resection of colorectal liver metastases: Results of a safety and feasibility study in the Netherlands
Abstract: Background: The 10-year overall survival with adjuvant hepatic arterial infusion pump (HAIP) chemotherapy after resection of colorectal liver metastases (CRLMs) was 61% in clinical trials from Memorial Sloan Kettering Cancer Center. A pilot study was performed to evaluate the safety and feasibility of adjuvant HAIP chemotherapy in patients with resectable CRLMs. Study Design: A phase II study was performed in two centers in The Netherlands. Patients with resectable CRLM without extrahepatic disease were eligible. All patients underwent complete resection and/or ablation of CRLMs and pump implantation. Safety was determined by the 90-day HAIP-related postoperative complications from the day of pump placement (Clavien–Dindo classification, grade III or higher) and feasibility by the successful administration of the first cycle of HAIP chemotherapy. Results: A total of 20 patients, with a median age of 57 years (interquartile range [IQR] 51–64) were included. Grade III or higher HAIP-related postoperative complications were found in two patients (10%), both of whom had a reoperation (without laparotomy) to replace a pump with a slow flow rate or to reposition a flipped pump. No arterial bleeding, arterial dissection, arterial thrombosis, extrahepatic perfusion, pump pocket hematoma, or pump pocket infections were found within 90 days after surgery. After a median of 43 days (IQR 29–52) following surgery, all patients received the first dose of HAIP chemotherapy, which was completed uneventfully in all patients. Conclusion: Pump implantation is safe, and administration of HAIP chemotherapy is feasible, in patients with resectable CRLMs, after training of a dedicated multidisciplinary team. © 2019, The Author(s).
Journal Title: Annals of Surgical Oncology
Volume: 26
Issue: 13
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2019-12-01
Start Page: 4599
End Page: 4607
Language: English
DOI: 10.1245/s10434-019-07973-w
PUBMED: 31641947
PROVIDER: scopus
DOI/URL:
Notes: Source: Scopus
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MSK Authors
  1. William R Jarnagin
    621 Jarnagin
  2. T Peter Kingham
    317 Kingham
  3. Nancy Kemeny
    409 Kemeny