Percutaneous Isolated Hepatic Perfusion as a Treatment for Isolated Hepatic Metastases of Uveal Melanoma: Patient Outcome and Safety in a Multi-centre Study

Journal Article · Thu Jun 15 04:00:00 EDT 2017 · Cardiovascular and Interventional Radiology

DOI:https://doi.org/10.1007/S00270-017-1588-2· OSTI ID:22645171

Lotz, Gösta ^[1]; Gebauer, Bernhard ^[2]; Willinek, Winfried ^[3]; Engelke, Christoph ^[4]; Brüning, Roland; Zeile, Martin ^[5]; Wacker, Frank ^[6]; Vogel, Arndt ^[7]; Radeleff, Boris ^[8]; Scholtz, Jan-Erik ^[9]

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1. University Hospital Frankfurt, Department of Anesthesiology, Intensive-Care Medicine and Pain Therapy (Germany)
2. Universitätsmedizin Berlin, Department of Diagnostic and Interventional Radiology, Campus Charité Mitte (Germany)
3. Brüderkrankenhaus Trier, Department of Diagnostic and Interventional Radiology (Germany)
4. Evangelisches Krankenhaus Göttingen-Weende gGmbH, Department of Diagnostic and Interventional Radiology (Germany)
5. Asklepios Klinik Barmbek, Department of Diagnostic and Interventional Radiology (Germany)
6. Medizinische Hochschule Hannover, Department of Diagnostic and Interventional Radiology (Germany)
7. Medizinische Hochschule Hannover, Department of Gastroenterology, Hepatology and Endocrinology (Germany)
8. Heidelberg University Hospital, Department of Diagnostic and Interventional Radiology (Germany)
9. University Hospital Frankfurt, Department of Diagnostic and Interventional Radiology (Germany)

PurposePercutaneous isolated hepatic perfusion (PIHP) with Melphalan has been developed as a treatment for patients with isolated hepatic metastases of uveal melanoma. We discuss patient outcome and safety in a retrospective multi-centre study.Materials and MethodsBetween 2012 and 2016 18 patients with un-resectable isolated hepatic metastases of uveal melanoma received single or repeated PIHP with Melphalan (n = 35) at seven sites. Progression-free time, overall survival time (OS) and tumour response by means of RECIST 1.1 criteria were evaluated. Peri- and post-procedural adverse events (AE) were registered. Patients’ life quality was assessed using four-point scale questionnaires.ResultsOf 18 patients, initial PIHP treatment resulted in partial response (PR) in eight, stable disease (SD) in seven and progressive disease (PD) in three cases. Nine patients underwent second PIHP with PR in eight cases and PD in one case. Six patients were evaluated after third PIHP with PR in five patients and SD in one patient. Two patients received fourth PIHP with PD in both cases. Median OS was 9.6 months (range 1.6–41.0 months). Median progression-free survival time was 12.4 months (range 0.9–41.0 months) with 1-year survival of 44%. Most common post-procedural AE grade 3 and 4 were temporary leukopenia (n = 11) and thrombocytopenia (n = 8). Patients’ self-assessments showed good ratings for overall health and quality of life with only slight changes after PIHP, and a high degree of satisfaction with PIHP treatment.ConclusionPIHP with Melphalan proved to be a relatively safe, minimal-invasive and repeatable treatment for patients with non-resectable hepatic metastases of uveal melanoma.

• OSTI ID: 22645171
• Journal Information: Cardiovascular and Interventional Radiology, Journal Name: Cardiovascular and Interventional Radiology Journal Issue: 6 Vol. 40; ISSN 0174-1551; ISSN CAIRDG
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
AUGER ELECTRON SPECTROSCOPY
LEUKOPENIA
LIVER
MELANOMAS
METASTASES
PATIENTS
SAFETY
SURVIVAL TIME