Chemosaturation via percutaneous hepatic artery perfusion and hepatic vein isolation for primary or metastatic liver cancer

NICE interventional procedures guidance [IPG488] Published date:

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The National Institute for Health and Care Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Chemosaturation via percutaneous hepatic artery perfusion and hepatic vein isolation for primary or metastatic liver cancer, in May 2014.

  • Description

    The most common types of primary liver cancer are hepatocellular carcinoma (also known as hepatoma) and cholangiocarcinoma. However, cancer occurs more often as a result of metastases from other sites such as the lung, colon, stomach and eye (particularly ocular melanoma).

    Treatment for primary or metastatic liver cancer depends on the location and stage of the cancer and how well liver function is preserved. Treatment options include surgical resection, thermal ablation, systemic chemotherapy, transarterial chemoembolisation and selective internal radiation therapy. Liver transplantation may be appropriate for some patients. In patients with primary liver cancer, surgical removal with curative intent may be possible. For most patients with liver metastases, treatment with curative intent is not possible.

    Regional hepatic arterial delivery of high-dose chemotherapy with isolated hepatic perfusion used to be done using open surgical techniques, which carried a risk of significant morbidity and mortality. It is now done percutaneously: this means that the procedure is less invasive and it can also be repeated.

  • OPCS4.6 Code(s)

    J10.3 Percutaneous transluminal injection of therapeutic substance into liver

    Y53.2 Approach to organ under ultrasonic control

    Z37.6 Hepatic artery

    X70-X71 Procurement of drugs for chemotherapy for neoplasm Bands 1-10 (depending on the cytotoxic drug used)

    X72 Delivery of chemotherapy for neoplasm (the delivery code is for outpatients and day cases only)

    X33.8 Other specified other blood transfusion

    In addition an ICD-10 code from category C22 Malignant neoplasm of liver and intrahepatic bile ducts, or code C78.7 Secondary malignant neoplasm of liver and intrahepatic bile duct would be recorded.

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