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Sequence of regional chemotherapy and surgery. Management of colorectal adenocarcinoma confined to the liver.

Four patients with clinically nonresectable unilobar hepatic metastases from colorectal cancer were treated with a sequentially combined approach of intrahepatic arterial chemotherapy followed by surgery. Partial regression (greater than or equal to 50%) induced by chemotherapy and associated with a decline in plasma carcinoembryonic antigen level was followed successfully by a complete hepatic tumor resection in three out of four patients. All three patients continue to be free of disease from 13+ to 21+ months. This combined approach may improve the salvage rate of patients with regionally confined hepatic metastases.