Perioperative hepatic arterial infusion pump chemotherapy is associated with longer survival after resection of colorectal liver metastases: A propensity score analysis

Bas Groot Koerkamp, Eran Sadot, Nancy E. Kemeny, Mithat Gönen, Julie N. Leal, Peter J. Allen, Andrea Cercek, Ronald P. DeMatteo, T. Peter Kingham, William R. Jarnagin, Michael I. D’Angelica

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To investigate whether perioperative hepatic arterial infusion pump chemotherapy (HAI) was associated with overall survival (OS) in patients who had a complete resection of colorectal liver metastases (CLM). Methods: Patients who underwent a complete resection of CLM between 1992 and 2012 were included from a single-center prospectively maintained database. All patients who received HAI also received perioperative systemic chemotherapy. Propensity score analysis was used to match patients for seven known prognostic factors. Results: A total of 2,368 consecutive patients underwent a complete resection of CLM, with a median followup of 55 months. The median OS for patients with HAI (n = 785) was 67 months versus 44 months without HAI (n = 1,583; P, .001), despite more advanced disease in the HAI group. OS at 10 years was 38.0% versus 23.8% without HAI. For patients who received modern systemic chemotherapy (n = 1,442), the median OS was 67 months with HAI and 47 months without HAI (P, .001). The hazard ratio adjusted by propensity score demonstrated longer OS with HAI: 0.67 (95% CI, 0.59 to 0.76; P, .001). A pronounced difference in median OS was found for patients with node-negative colorectal cancer (129 months with HAI v 51 months without; P, .001) and a low clinical risk score of 0 to 2 points (89 months with HAI v 53 months without; P, .001). Conclusion: Patients who received HAI had a median OS of approximately 2 years longer than patients without HAI. The strong association was independent of the use of modern systemic chemotherapy and remained in propensity score analysis. Patients with node-negative primary tumors or a low clinical risk score seemed to benefit most from HAI.

Original languageEnglish
Pages (from-to)1938-1944
Number of pages7
JournalJournal of Clinical Oncology
Volume35
Issue number17
DOIs
StatePublished - 10 Jun 2017

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