Over a 9‐year period (1960–1968), 243 patients with liver metastases from colorectal carcinoma were treated by the continuous infusion of fluorouracil, methotrexate, cyclophosphamide, vinblastine, and vincristine, singly or in combination, into the aorta at a level above the celiac artery for a period of 14 days or longer. The common femoral, and on occasion the brachial, artery was percutaneously cannulated with the employment of an 18‐gauge thin‐wall needle through which was introduced a catheter, preferably teflon, and the distal catheter‐tip critically positioned into the aorta as determined by fluorescein dye injection or, if necessary, by radiologic visualization. This study was designed to determine the response of metastatic liver carcinoma to the infusion of cytotoxic agents into the critical aortic level on the premise that total abdominal infusion is more effective than selective hepatic infusion because of the common presence of other intra‐abdominal metastases and because the liver has two major arterial pathways (from the celiac and superior mesenteric arteries) with frequent variations. Eighty‐eight (36.2%) of the 243 patients obtained an objective response of 6 to 30 months' duration. The median survival time of the responders with colon carcinoma was 12.0 months as opposed to 4.0 months for the non‐responders. The rectal carcinoma responders had a median survival time of 12.2 and the non‐responders 3.2 months. No major complications occurred. The minor complication rate was 9.1%. This simplified bedside procedure for liver and intra‐ abdominal drug infusion has produced significant clinical results without serious infusion complications or major adverse drug effects in the dosage regimens used. It has increased survival (the significant parameter for evaluation) threefold over that of the non‐responders. This modality of chemotherapy can be utilized in the treatment of any metastatic liver neoplasm.
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