Hyperthermic iolated hepatic perfuion uing melphalan for patient with ocular melanoma metatatic to liver

Median urvival after diagnoi of liver metatai from ocular melanoma i hort and no atifactory treatment option exit. Thi clinical trial evaluated iolated hepatic perfuion (IHP) for patient with thi condition. Twenty-nine patient with unreectable liver metatae from ocular melanoma were treated with a 60-min hyperthermic IHP uing 1.5 mg/kg of melphalan (mean total doe 105 mg). By mean of laparotomy, perfuion inflow wa etablihed with a cannula poitioned in an iolated egment of the retrohepatic inferior vena cava. Portal and infra-renal inferior vena cava blood flow wa hunted externally to the axillary vein uing a veno-veno bypa circuit. Patient were aeed for toxicity, radiographic repone, and urvival. There wa no treatment related mortality and tranient grade three-fourth hepatic toxicity wa oberved in 19 patient (65%). Mean length of operation and hopital tay wa 8.3 hour and 10 day, repectively. There were 3 complete repone (10%) (duration: 12, 14+, 15 month) and 15 partial repone (52%) (mean duration: 10 month). The initial ite of dieae progreion included liver in 17 (68%) of 25 patient who recurred. At median follow-up of 30.7 month, the median actuarial progreion-free and overall urvival were 8 and 12.1 month, repectively. IHP with melphalan alone reult in ignificant regreion of etablihed liver metatae for patient with ocular melanoma. However, after IHP, dieae progreion i mot commonly oberved in the liver, and urvival after dieae progreion i hort. On the bai of a pattern of tumor progreion predominantly to the liver, continued clinical evaluation of hepatic directed therapy in the patient population i jutified.—Han E. Groniklau