379 Background: The role of intrahepatic pump chemotherapy (HAI) in the treatment of liver metastasis is still controversial. Our study was performed to evaluate the adjunctive role of HAI in patients (pts) with colorectal liver metastasis (CLM) treated with major hepatic resection and systemic chemotherapy (Systemic Rx). Methods: A retrospective analysis was performed on pts with histologically confirmed CLM who had major liver resection and/or radiofrequency ablation and received systemic Rx with HAI and compared with pts without HAI. Primary outcome was overall survival. Exclusion criteria included a second cancer, refusal of chemotherapy, loss of follow-up and minor resection or biopsy alone. Statistical analysis was done using Kaplan-Meyer survival curves. Results: Consecutive 66 pts with CLM were analyzed, of which 13 pts were lost to follow-up. Out of 53 pts undergoing systemic Rx and major liver resection, 37 pts had HAI with 5-fluorouracil (gp A) and 16 pts had no HAI (gp B). Both groups received similar systemic Rx ( Table 1). There was no HAI related mortality in gp A. Pts with minimum follow-up of 3 years were included for survival analysis. The overall 3-year survival of gp A was 36% (12 pts out of 33) compared to 23 % (3 pts out of 13 pts) in gp B. Due to small sample size statistical significance was not achieved. Conclusions: Pts with CLM who undergo systemic Rx with HAI along with major hepatic resection or ablation may survive longer than pts with systemic Rx without HAI. A larger multicenter study is warranted. [Table: see text]