title: Isolated (hypoxic) hepatic perfusion with high-dose chemotherapy in patients with unresectable liver metastases of uveal melanoma: results from two experienced centres.
abstract: Uveal melanoma patients have a poor survival after the diagnosis of metastatic disease. Isolated hepatic perfusion (IHP) was developed to treat patients with unresectable metastases confined to the liver. This retrospective analysis focuses on treatment characteristics, complications, toxicity and survival after IHP. Patients with uveal melanoma metastases confined to the liver treated with IHP in two experienced hepato-pancreatic-biliary surgery centres (Erasmus MC Cancer Institute and Leiden University Medical Center) were included. Between March 1999 and April 2009, 30 patients were treated with IHP. The duration of surgery was 3.7 h (Erasmus MC Cancer Institute) versus 8.7 h (Leiden University Medical Center) and also the dosage of melphalan differed: 1 mg/kg body weight (n=12) versus a dose of 170-200 mg (n=18) or melphalan (100 mg) combined with oxaliplatin (50 or 100 mg) (n=3). The length of hospital stay was 10 days. Two patients developed occlusion of the hepatic artery and died, respectively, 3 days and 1.5 months after surgery. Progression-free survival was 6 (1-16) months and recurrences occurred mainly in the liver. The median overall survival was 10 (3-50) months. IHP is a potentially beneficial treatment modality resulting in a reasonable overall survival for uveal melanoma patients. Because of considerable morbidity related to the open procedure, a percutaneous system has been developed and is currently being investigated.
authors: Departments of aSurgery bRadiology cMedical Oncology dOphthalmology eExtra Corporal Circulation, Leiden University Medical Center, Leiden fDepartment of Surgery, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
authors: Eleonora M
authors: EM
authors: de Leede
authors: Mark C
authors: MC
authors: Burgmans
authors: Ellen
authors: E
authors: Kapiteijn
authors: Gre P M
authors: GP
authors: Luyten
authors: Martine J
authors: MJ
authors: Jager
authors: Fred G J
authors: FG
authors: Tijl
authors: Henk H
authors: HH
authors: Hartgrink
authors: Dirk J
authors: DJ
authors: Grünhagen
authors: Joost
authors: J
authors: Rothbarth
authors: Cornelis J H
authors: CJ
authors: van de Velde
authors: Cornelis
authors: C
authors: Verhoef
authors: Alexander L
authors: AL
authors: Vahrmeijer
mesh_terms: D000368:Aged; D015687:Cell Hypoxia; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary*; D008297:Male; D008545:Melanoma / Q000150:complications* / Q000401:mortality / Q000473:pathology; D008875:Middle Aged; D010477:Perfusion; D012878:Skin Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology; D016019:Survival Analysis; D014604:Uveal Neoplasms / Q000150:complications* / Q000401:mortality / Q000473:pathology; D000098943:Uveal Melanoma