The effective management of diffuse intrahepatic cancer is a challenging but potentially rewarding problem. From 50% to 75% of patients who die from cancer have metastases in the liver,1 but of more significance is the fact that hepatic metastases often prevent cure although the primary lesion can be controlled by surgical resection.2 In one autopsy series intrahepatic metastases were the only ones encountered in 19% of 59 patients who died with cancer of the colon.3 In a previous study of 390 patients with untreated hepatic metastases at this institution the progress of cancer within the liver appeared to have the dominant influence upon survival despite the presence of metastases in other sites and survival was usually brief.4
Surgery and irradiation are of little practical value in management. Systemic chemotherapy, even with the most effective of drugs currently available, is of limited value, as regressions can be
Donegan WL, Harris HS, Spratt JS. Prolonged Continuous Hepatic Infusion: Results With Fluorouracil for Primary and Metastatic Cancer in the Liver. Arch Surg. 1969;99(2):149–157. doi:10.1001/archsurg.1969.01340140021004
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