Immediate results of treatment of patients with metastatic uveal melanoma using isolated liver chemoperfusion. The first domestic experience

Abstract

Introduction. Uveal melanoma is the most common primary intraocular tumor in adults. Despite some achievements in primary tumor treatment, 50% of patients develop distant metastases in various times (3 years to decades). Hematogenous spread is typical for uveal melanoma, and in 90% of the cases liver is the target. Median survival of patients with liver metastases is 4 to 9 months according to various researchers. And the result of treatment is extremely poor, unlike the results of skin melanoma treatment.The aim is to evaluate the immediate results of treatment of patients with uveal melanoma metastatic to the liver using isolated hepatic perfusion technique.Materials and methods. Considering a high risk of developing a metastatic liver disease in patients with uveal melanoma, local therapy is particularly interesting. This article describes the results of 10 metastatic uveal melanoma patients’ Isolated Hepatic Perfusion (IHP) Treatment. IHP was conducted using the standard methods with 100 mg of Melphalan for 60 min.Results and discussion. IHP treatment shows low complication rate. The data for response assessment is available on 9 out of 10 patients, because 10th patient received this treatment less than a month ago. Follow-ups a month after 9 patients underwent IHP showed an objective response to treatment in 6 patients (complete response in 1, partial response in 5 patients).Conclusion. The use of isolated liver chemoperfusion in a small group of patients according to the standard procedure allowed achieving an immediate response in 67% of cases.

Keywords

• uveal melanoma
• isolated liver chemoperfusion
• liver metastases
• melphalan
• regional treatment
• stage iv
• progression