TY - JOUR
T1 - Adjuvant Hepatic Arterial Infusion Pump Chemotherapy After Resection of Colorectal Liver Metastases
T2 - Results of a Safety and Feasibility Study in The Netherlands
AU - Buisman, Florian E
AU - Grünhagen, Dirk J
AU - Homs, Marjolein Y V
AU - Grootscholten, Cecile
AU - Filipe, Wills F
AU - Kemeny, Nancy E
AU - Cercek, Andrea
AU - D'Angelica, Micheal I
AU - Donswijk, Maarten L
AU - van Doorn, Leni
AU - Emmering, Jasper
AU - Jarnagin, William R
AU - Kingham, T Peter
AU - Klompenhouwer, Elisabeth G
AU - Kok, Niels F M
AU - Kuiper, Maria C
AU - Moelker, Adriaan
AU - Prevoo, Warner
AU - Versleijen, Michelle W J
AU - Verhoef, Cornelis
AU - Kuhlmann, Koert F D
AU - Groot Koerkamp, Bas
N1 - FUNDING:
Funding was received from Erasmus MC Efficiency
(Mrace), Erasmus MC Foundation, Coolsingel Foundation, and Tricumed GmBh (in kind).
PY - 2019/12
Y1 - 2019/12
N2 - 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.
AB - 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.
U2 - 10.1245/s10434-019-07973-w
DO - 10.1245/s10434-019-07973-w
M3 - Article
C2 - 31641947
SN - 1068-9265
VL - 26
SP - 4599
EP - 4607
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 13
M1 - WOS:000506884200062
ER -
