The results suggest that, compared with historical controls, high-dose focal liver irradiation with hepatic artery floxuridine prolongs survival in patients with unresectable chemotherapy-refractory metastatic colorectal cancer and primary hepatobiliary tumors. This provides a rationale for intensification of local therapy for unresectable hepatobiliary cancers and integration of this regimen with newer systemic therapy for patients with colorectal cancer.

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Background: Hepatic resection has become common in the United States for both primary and secondary hepatic tumors. Hypothesis: Variation in outcomes after hepatic resection is related to patient characteristics, the indication for operation, and hospital procedural volume. Design: Observational study using a nationally representative database. Patients: All patients in the Nationwide Inpatient Sample for 1996 and 1997 with a primary procedure code for hepatic resection (N = 2097). Main Outcome Measures: Outcomes included inhospital mortality and length of stay. Risk-adjusted analyses were performed using hierarchical multivariate models. Results: Overall mortality for the 2097 patients was 5.8%. The most common indications for hepatic resection were