Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma

作者： Ilan Ben-Shabat1,4, Christoffer Hansson2,4, Malin Sternby Eilard3,4, Christian Cahlin3,4, Magnus Rizell3,4, Per Lindnér3,4, Jan Mattsson1,4, Roger Olofsson Bagge1,4 1Department of Surgery,Institute of Clinical Sciences, 2Department of Thoracic Surgery,Institute of Clinical Sciences, 3Transplant Institute,Institute of Clinical Sciences, 4Sahlgrenska University Hospital,Sahlgrenska Academy at the University of Gothenburg

简介：

Overview

This article presents a detailed protocol for performing isolated liver perfusion (IHP) with melphalan, a treatment option for liver metastases of uveal melanoma. The procedure aims to deliver high concentrations of chemotherapy directly to the liver while minimizing systemic toxicity.

Key Study Components

Area of Science

• Oncology
• Hepatology
• Clinical Protocols

Background

• Uveal melanoma is the most common primary intraocular malignancy in adults.
• Approximately 50% of patients develop metastatic disease, primarily to the liver.
• The median survival for patients with liver metastasis is about six to twelve months.
• Isolated hepatic perfusion (IHP) is a technique designed to treat liver metastases while avoiding systemic toxicity.

Purpose of Study

• To describe the IHP procedure using melphalan for treating liver metastases from uveal melanoma.
• To evaluate the effectiveness and safety of IHP in clinical settings.
• To provide a comprehensive protocol for researchers and clinicians.

Methods Used

• Placement of catheters into femoral and external jugular veins for venous shunting.
• Clamping of the caval vein and insertion of catheters into the hepatic artery and caval vein.
• Connection to a heart-lung machine to facilitate perfusion.
• Perfusion of the liver with melphalan for 60 minutes at a controlled temperature.

Main Results

• The overall response rate to IHP for isolated liver metastasis of uveal melanoma is 61%.
• Complete response rate is reported at 8%.
• Median survival varies between nine and 24 months.
• Mortality rates associated with the procedure range from 0% to 22%.

Conclusions

• IHP with melphalan shows promise as a treatment for liver metastases from uveal melanoma.
• Further studies are needed to optimize patient selection and improve outcomes.
• The protocol provides a foundation for future research and clinical application.

Frequently Asked Questions