Hepatic Artery Ligation and Cytotoxic Infusion in Treatment of Liver Neoplasms

Zike, Wilbur L.; Safaie-Shirazi, Siroos; Gulesserian, H. P.

doi:10.1001/archsurg.1975.01360110187031

Cited by 32 publications

(4 citation statements)

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“…6~2 6 Thus, tumor regression after hepatic artery ligation is short-lived and there is definite reason to add chemotherapy either via branches of the portal vein'or the hepatic artery distally. 15, 45 For primary carcinoma of the liver there is currently no definite evidence that hepatic artery ligation, with or without added infusion chemotherapy to the liver gives better response and/or survival results than infusion chemotherapy through the hepatic artery alone. Ong and Chan3' of Hong Kong conducted the only randomized clinical trial comparing no treatment, radiotherapy, hepatic dearterialization, dearterialization and portal vein 5FU infusion, and intraarterial 5FU infusion.…”

Section: Discussionmentioning

confidence: 99%

“…'~ or portal vein, 40 ligation of hepatic a r t e r~~'~~ or portal branches,'" either singularly or in various combinations. 1.4, 45evaluable hepatoma patients responded to systemic adriamycin, with three exhibiting complete regression, and Vogel et al 43 reported a 25% objective response rate with high dose of intravenous adriamycin (7S/mg/M2, Q3wk). Since adriamycin is metabolized by the liver,7 it is suggested that hepatic artery infusion of adriamycin may allow a more aggressive treatment of hepatoma without a concomitant increase in systemic toxicity.…”

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confidence: 99%

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Hepatic artery ligation and adriamycin infusion chemotherapy for hepatoma

Lee¹,

Irwin²

1978

Cancer

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Two patients with hepatoma of the liver were treated with ligation of the hepatic artery and continuous infusion of adriamycin into the distal arterial branch. Both patients had tumor replacing 60-75% of the normal liver parenchyma. There was clinical improvement and objective shrinkage of the tumor by liver scan lasting for 5 and 7 months. But both cases died 7 and 11 months later, probably of cardiac toxicity (total dose of adriamycin = 500 mg/m2).

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Hepatic artery ligation and adriamycin infusion chemotherapy for hepatoma

Lee¹,

Irwin²

1978

Cancer

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“…Hepatic arterial occlusion for liver cancer has been widely used in an attempt to control tumor growth [1][2][3][4][5][6][7], since liver tumors have mainly an arterial blood supply [8][9][10]. Different surgical and nonsurgical procedures are being practiced: hepatic artery ligation [4,7], permanent dearterialization [1,2], transient dearterialization [3,11,12], and embolization with either degradable products [13,14] or nondegradable micromaterial [15].…”

Section: Hepatic Dearterialization and Permanent Hepatic Artery Iigat...mentioning

confidence: 99%

The prevention of arterial collaterals after repeated temporary blockade of the hepatic artery in pigs

et al. 1987

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Hepatic dearterialization and permanent hepatic artery ligation can induce tumor necrosis but only of limited duration, partly due to a rapid development of arterial collaterals. The aim of this study was to determine if collateral formation could be reduced or prevented by repeated, transient dearterialization.Three groups of pigs were repeatedly and transiently dearterialized daily for 2 hours (n=5), 4 hours (n=5), and 6 hours (n=4), respectively, over a 4‐week‐period by means of a totally implantable vascular occluder described earlier by us. These pigs were compared with a group having permanent hepatic dearterialization (n=4). An additional group (n=3) served as a control and did not have dearterialization. After 4 weeks of treatment, hepatic angiograms were taken and absolute hepatic arterial blood flow was measured according to the reference sample method with radiolabeled microspheres. There were no demonstrable collaterals in the 2‐hour group, formation of some small collaterals in the 4‐hour group, and a fully developed collateral network in the 6‐hour group, with similar findings in the permanently dearterialized group. Absolute hepatic arterial blood flow was significantly lower in the 4‐hour group with obstructed hepatic artery compared to permanent hepatic dearterialization (p<0.01, Wilcoxon rank sum test) and highly significantly lower in the 2‐hour group (p<0.0001, Wilcoxon rank sum test).Thus, repeated and brief dearterialization seems to prevent the formation of arterial collaterals and makes repeated arterial ischemia of the liver possible which could be of value in the treatment of liver tumors. In addition, a patent artery makes continuous intra‐arterial cytostatic infusion possible.

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“…They pointed out that all patients lived much longer than the expected median survival of patients with untreated hepatic metastasis (8.5 vs 2.5 months). In a later report of 38 patients, including four cases of hepatoma, the median survival of all patients, including two postoperative deaths (5% surgical mortality), was 13.3 months [95]. They emphasized that substantial palliation can be achieved by hepatic artery ligation and cytotoxic infusion.…”

Section: Hepatic Artery Ligation and Infusion Chemotherapymentioning

confidence: 99%

Nonsystemic treatment of metastatic tumors of the liver—a review

Lee

1978

Med. Pediatr. Oncol.

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Hepatic metastasis is usually quite resistant to conventional systemic chemotherapy. Nonsystemic treatment of metastatic tumors of the liver include surgical resection; infusion of chemotherapeutic agent(s), either via hepatic artery or portal vein; ligation of hepatic artery; radiotherapy; and other more investigative approaches (isolation perfusion, cryosurgery, liver transplantation, etc). The relative applicability, results, and limitations of each of these therapeutic modalities are reviewed.

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Hepatic Artery Ligation and Cytotoxic Infusion in Treatment of Liver Neoplasms

Cited by 32 publications

References 10 publications

Hepatic artery ligation and adriamycin infusion chemotherapy for hepatoma

Hepatic artery ligation and adriamycin infusion chemotherapy for hepatoma

The prevention of arterial collaterals after repeated temporary blockade of the hepatic artery in pigs

Nonsystemic treatment of metastatic tumors of the liver—a review

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