Colorectal Liver Metastases: Intra-arterial Pump Chemotherapy

The objective of this thesis was to develop clinical trials on hepatic arterial infusion pump (HAIP) chemotherapy in patients with resectable colorectal liver metastases (CRLM), and to study factors that are associated with prognosis and prediction in CRLM patients. The results of this thesis will be evaluated in three parts. Part I focused on the outcomes of perioperative HAIP and systemic chemotherapy in patients with resectable CRLM. In Part II results off a phase II safety and feasibility study on HAIP chemotherapy in the Netherlands were discussed. Additionally, a trial protocol of a multicenter phase III randomized controlled trial (RCT) was presented. This trial is currently running in the Netherlands and was designed to investigate the efficacy of HAIP chemotherapy after resection compared to resection only in patients with CRLM confined to the liver and a low clinical risk score (CRS). Part III focused on the prognostic and predictive value of clinical and pathological factors after resection of CRLM. In addition, models that predict individual patient outcome were evaluated