Hepatic perfusion: Surgical and catheter

Many solid organ malignancies including colorectal cancer (CRC), neuroendocrine tumors, and ocular melanoma frequently spread to the liver. Liver metastases in patients with these diseases are associated with a poor prognosis. Effective treatment of isolated tumors has remained difficult despite advances in targeted agents and chemotherapy. Isolatedhepatic perfusion (IHP) and percutaneous hepatic perfusion (PHP) are examples of liver-directed therapies which were developed to target hepatic metastases in such patients who are refractory to other treatments. The efficacy of these therapies is thought to be attributed to targeting the unique blood supply to hepatic metastases, the hepatic artery. This chapter will describe the techniques of both IHP and PHP and summarize the clinical data evaluating their effectiveness for patients with isolated liver metastases and the above malignancies.