Hyperthermic Isolated Liver Perfusion
The treatment involves an operation in which the blood vessels that supply the liver and drain the liver are isolated to create a blood flow circuit for the liver that is separate from the rest of the body. The liver is heated to 40° C (hyperthermia) and an extremely high dose of a chemotherapy agent (melphalan) is circulated in the liver. Because the blood flow in the liver is isolated from the blood flow of the remainder of the body, only the liver itself is subjected to the high dose of chemotherapy and the hyperthermia. The hyperthermia and chemotherapy together more effectively destroy cancer than either modality alone. At the end of the operation, the normal blood flow of the liver is re-established. This procedure has been performed on over 150 patients at the National Cancer Institute, with demonstration of safety and efficacy. This clinical trial at the Massachusetts General Hospital is performed as a collaboration between liver specialists in the Surgical Oncology and Transplant surgery, and is designed to examine safety and feasibility of this treatment when performed at a center other than the National Cancer Institute. Patients with unresectable liver tumors from colon or rectal cancer, ocular melanoma, neuroendocrine tumors (including carcinoid), and cholangiocarcinoma are eligible. Patients must have no evidence of cancer outside the liver, and should not have either hepatitis or cirrhosis.