Treatment of liver metastases from uveal melanoma by combined surgery—chemotherapy

To investigate sporadic results demonstrating prolonged survival after surgical resection and/or intraarterial chemotherapy (IACH) for liver metastases from uveal melanoma. From December 1992 to March 1997 every patient with liver metastases from uveal melanoma was enrolled in a prospective study in...

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Published in:	European journal of surgical oncology Vol. 24; no. 2; pp. 127 - 130
Main Authors:	Salmon, R.J., Levy, C., Plancher, C., Dorval, T., Desjardins, L., Leyvrazi, S., Pouillart, P., Schlienger, P., Servois, V, Asselain, B.
Format:	Journal Article
Language:	English
Published:	Amsterdam Elsevier Ltd 01-04-1998 Elsevier
Subjects:	Adult Aged Antineoplastic Combined Chemotherapy Protocols - administration & dosage Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Catheters, Indwelling chemotherapy Chemotherapy, Adjuvant Cisplatin - administration & dosage Female Humans Infusions, Intra-Arterial liver metastasis Liver Neoplasms - drug therapy Liver Neoplasms - secondary Liver Neoplasms - surgery Male Medical sciences Melanoma - drug therapy Melanoma - secondary Melanoma - surgery Middle Aged Nitrosourea Compounds - administration & dosage Ophthalmology Organophosphorus Compounds - administration & dosage Prospective Studies surgery Survival Analysis Treatment Outcome Tumors and pseudotumors of the eye, orbit, eyelid, lacrimal apparatus uveal melanoma Uveal Neoplasms - pathology liver metastasis chemotherapy uveal melanoma surgery Antineoplastic agent Human Treatment efficiency Liver Hepatic disease Uvea disease Malignant tumor Metastasis Eye disease Chemotherapy Treatment Uvea Surgery Malignant melanoma Digestive diseases Combined treatment
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Summary:	To investigate sporadic results demonstrating prolonged survival after surgical resection and/or intraarterial chemotherapy (IACH) for liver metastases from uveal melanoma. From December 1992 to March 1997 every patient with liver metastases from uveal melanoma was enrolled in a prospective study including: (1) aggressive surgical approach removing as much liver disease as possible; (2) implantation of an intraarterial catheter; (3) intraarterial chemotherapy for 6 months. 75 patients were enrolled: 38 men, 37 women, mean age 51 years (range: 18–72), mean time from initial diagnosis of uveal melanoma to liver metastases 37 months (ranged: 1–168). Disseminated disease in both lobes was present in all but one patient. Macroscopically curative surgery was possible in 27.5%. Significant tumour reduction was performed in 49.3% and a simple biopsy was possible in 23.2%. Eight patients did not receive chemotherapy and died soon after. IACH included Fotemustine and/or DTIC-Platinum for 4–9 cycles. Overall median survival was 9 months; very similar to non-operated historical controls. In the 61 patients receiving complete treatment surgery plus chemotherapy, median survival improved to 10 months. When curative resection was possible, survival increased to 22 months (P<0.001). Aggressive surgical resection, when possible, appears to be the best method of improving survival of liver metastases from uveal melanoma. New drug combinations are also required to improve survival.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0748-7983 1532-2157
DOI:	10.1016/S0748-7983(98)91485-8