TY - JOUR
T1 - Long-Term Follow-Up Evaluation of 68 Patients with Uveal Melanoma Liver Metastases Treated with Isolated Hepatic Perfusion
AU - Ben-Shabat, Ilan
AU - Belgrano, Valerio
AU - Ny, Lars
AU - Nilsson, Jonas
AU - Lindnér, Per
AU - Olofsson Bagge, Roger
PY - 2016/4/1
Y1 - 2016/4/1
N2 - BACKGROUND: This report describes the outcomes and long-term follow-up data from all isolated hepatic perfusions (IHPs) performed at a single institution in Sweden between the years 1989 and 2013 for patients with isolated uveal melanoma metastases.METHODS: A total of 68 patients (median age, 61 years) were treated consecutively at Sahlgrenska University Hospital. Of the 68 patients, 67 % had fewer than 10 tumors. The median diameter of the largest lesion was 2.5 cm. The patients underwent IHP with either melphalan alone or the addition of either tumor necrosis factor-alpha or cisplatin. The response was assessed after 8-12 weeks by computed tomography or magnetic resonance imaging.RESULTS: The overall response rate was 67 and 20 % of the patients had a complete response. The median times to local and systemic progression were respectively 10 and 14 months. The prognostic factors for time to local recurrence were response and number of tumors. The median survival time was 22 months. The prognostic factors for survival were response, largest tumor diameter, and number of tumors. Five patients (7 %) died within 30 days, and six patients (9 %) experienced major complications (Clavien-Dindo 3/4).CONCLUSIONS: Isolated hepatic perfusion is a treatment option with high response rates and tolerable mortality and morbidity. Whether IHP has a survival benefit compared with other treatment options currently is being investigated in a randomized trial.
AB - BACKGROUND: This report describes the outcomes and long-term follow-up data from all isolated hepatic perfusions (IHPs) performed at a single institution in Sweden between the years 1989 and 2013 for patients with isolated uveal melanoma metastases.METHODS: A total of 68 patients (median age, 61 years) were treated consecutively at Sahlgrenska University Hospital. Of the 68 patients, 67 % had fewer than 10 tumors. The median diameter of the largest lesion was 2.5 cm. The patients underwent IHP with either melphalan alone or the addition of either tumor necrosis factor-alpha or cisplatin. The response was assessed after 8-12 weeks by computed tomography or magnetic resonance imaging.RESULTS: The overall response rate was 67 and 20 % of the patients had a complete response. The median times to local and systemic progression were respectively 10 and 14 months. The prognostic factors for time to local recurrence were response and number of tumors. The median survival time was 22 months. The prognostic factors for survival were response, largest tumor diameter, and number of tumors. Five patients (7 %) died within 30 days, and six patients (9 %) experienced major complications (Clavien-Dindo 3/4).CONCLUSIONS: Isolated hepatic perfusion is a treatment option with high response rates and tolerable mortality and morbidity. Whether IHP has a survival benefit compared with other treatment options currently is being investigated in a randomized trial.
KW - Adolescent
KW - Adult
KW - Aged
KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
KW - Chemotherapy, Cancer, Regional Perfusion
KW - Cisplatin/administration & dosage
KW - Extracorporeal Circulation
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Liver Neoplasms/drug therapy
KW - Male
KW - Melanoma/drug therapy
KW - Melphalan/administration & dosage
KW - Middle Aged
KW - Neoplasm Staging
KW - Prognosis
KW - Survival Rate
KW - Tumor Necrosis Factor-alpha/administration & dosage
KW - Uveal Neoplasms/drug therapy
KW - Young Adult
UR - http://www.scopus.com/inward/record.url?scp=84949488238&partnerID=8YFLogxK
U2 - 10.1245/s10434-015-4982-5
DO - 10.1245/s10434-015-4982-5
M3 - Article
C2 - 26628434
SN - 1068-9265
VL - 23
SP - 1327
EP - 1334
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 4
ER -
