Is it possible for an inoperable tumor to become operable?

This study examined the effect of hepatic-artery infusion combined with systemic chemotherapy on patients with inoperable colorectal liver metastases. 

Any cancer involving the colon or rectum is called colorectal cancer. Frequently, this cancer spreads to the liver (colorectal liver metastasis), and often in this case the tumors are found to be unresectable (cannot be removed by surgery). Other than surgery, chemotherapy can be used to treat this disease, and one way of delivering the chemotherapeutic drugs to the cancer site is hepatic-artery infusion (HAI). This describes a form of chemotherapy whereby a thin flexible tube is placed into the hepatic artery (the main artery of the liver), directly delivering chemotherapy drugs (such as floxuridine) to the liver. 

The study focused on 49 patients diagnosed with inoperable colorectal liver metastases. Patients were given general chemotherapy combined with HAI–floxuridine combined with bevacizumab (Avastin). Patients were divided into two groups, with one receiving oxaliplatin (Eloxatin) and one group not receiving oxaliplatin. After treating the initial 24 patients, it was found that bevacizumab caused high toxicity and so was not administered to the remaining patients.

Of the patients treated, 76% exhibited a response to treatment, with the majority seeing a decrease in the size or extent of the tumors. 47% of patients were able to undergo surgery for removal of metastases after treatment. Patients who had the surgery had a higher 3-year survival rate (80%) compared to those who did not have the surgery (26%). 20% of the patients had no signs of the disease upon study follow-up at approximately 39 months.

The study found that non-operable CRLM patients treated with chemotherapy supplied through HAI became operable and had higher survival rates.

Whether the cancer was resectable or not was decided by 3 professionals as opposed to objective guidelines, so there may be different results if the study was repeated.