Patients
blood loss, BOR
BLOOD LOSS, METASTASIS, METASTASES
From July 2013 to March 2021, 147 patients were screened and 93 patients were enrolled at six sites and randomly assigned to the IHP group (46 patients) or the control group (47 patients). Six patients were excluded after random assignment but before treatment initiation, four because of not fulfilling the inclusion criteria (two patients because of metastasis occupying >50% of the liver, one patient because of the presence of systemic metastases, and one patient where the metastasis was not verified by biopsy), and two patients withdrew their consent (Fig CONSORT diagram. Baseline Patient CharacteristicsAmong patients in the IHP group, 41 (89%) were treated PP and two (4.5%) did not receive IHP because of the perioperative observation that >50% of the liver was occupied with metastases, so these patients immediately crossed over to the control arm. In the IHP group, the median operating time was 5.0 hours (range, 1.0-8.0 hours) and the median hospital stay was 7 days (range, 4-21 days). The median perioperative liver temperature was 40°C (range, 39°C-40°C), the median perfusion flow rate was 600 mL/min (range, 50-1,020 mL/min), and the median blood loss was 600 mL (range, 0-2,400 mL). Among the patients in the control group, the first-line treatment was chemotherapy in 21 (48%) patients, ICIs in 17 (39%) patients, and localized treatment interventions in five (11%) patients. One (3%) patient did not receive any antitumor treatment because of clinical deterioration (Table BOR as Assessed by RECIST 1.1