Downstaging des métastases hépatiques d'origine colorectale et des carcinomes hépatocellulaires par chimiothérapie sélective intra-artérielle hépatique

While resection is the sole chance of cure in patients with hepatocellular carcinoma or metastatic colorectal cancer to the liver, many patients are not candidates for surgery at the time of diagnosis. Strategies aiming at downstaging large or multi-focal tumors to enable curative resection are appealing. Neoadjuvant hepatic intra-arterial chemotherapy is a safe and well tolerated technique. We studied its effects in patients with unresectable hepatocellular carcinoma or metastatic colorectal cancer to the liver in the absence of extra-hepatic disease. Our results demonstrated successful downstaging of initial tumors followed by curative resection. The success of this strategy however requires a multidisciplinary approach in a hepato-biliary center with extensive experience in the management of these patients.