The history of isolated hepatic perfusion for liver metastases and current indications for use

Unresectable liver metastases are a frequent cause of cancer-related mortality in a variety of solid tumors. While cytotoxic therapies may offer meaningful improvements in overall survival for some cancers (e.g., colorectal cancer), other tumor types, such as ocular melanoma, have limited effective therapies. Isolated hepatic perfusion allows for regional delivery of cytotoxic drugs to the liver with limited systemic side effects. Furthermore, isolated hepatic perfusion has been shown to improve outcomes in select patients with diffuse liver metastasis. The technique has been refined over the past few decades. When performed at specialized centers, isolated hepatic perfusion is associated with low morbidity and mortality.