Vol. 27 No. 3 (2023)
ONCOLOGY

Isolated hepatic perfusion for metastases of uveal melanoma: hospital outcomes

pdf (Русский)
  • V.M. Unguryan,
  • A.N. Kazantsev,
  • A.V. Korotkikh,
  • S.A. Ivanov,
  • Yu.V. Belov,
  • A.D. Kaprin
V.M. Unguryan
Kostroma Regional Cancer Center, Kostroma
Bio
A.N. Kazantsev
Kostroma Regional Cancer Center, Kostroma; Petrovsky National Research Centre of Surgery, Moscow; Ye.I. Korolyov Kostroma Regional Clinical Hospital, Kostroma
A.V. Korotkikh
Amur State Medical Academy, Blagoveshchensk
S.A. Ivanov
A. Tsyb Medical Radiological Research Center, National Medical Research Radiological Centre, Obninsk
Yu.V. Belov
Petrovsky National Research Centre of Surgery, Moscow; Sechenov University, Moscow
A.D. Kaprin
P. Hertsen Moscow Oncology Research Institute, National Medical Research Radiological Centre, Moscow
DOI: https://doi.org/10.21688/1681-3472-2023-3-74-82

Published 2023-09-29

Keywords

  • Liver,
  • Liver Disease,
  • Perfusion,
  • Uveal Melanoma

How to Cite

Unguryan, V., Kazantsev, A., Korotkikh, A., Ivanov, S., Belov, Y., & Kaprin, A. (2023). Isolated hepatic perfusion for metastases of uveal melanoma: hospital outcomes. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 27(3), 74–82. https://doi.org/10.21688/1681-3472-2023-3-74-82

Copyright (c) 2023 Unguryan V.M., Kazantsev A.N., Korotkikh A.V., Ivanov S.A., Belov Yu.V., Kaprin A.D.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Objective: To evaluate hospital outcomes of isolated hepatic perfusion for metastases of uveal melanoma.
Methods: In 2020-2022, 38 isolated hepatic perfusion procedures for unresectable metastases of uveal melanoma were performed in the Kostroma Regional Cancer Center. Our study included the following complications: death, bleeding, tumor lysis syndrome, abscess in the left lobe of the liver, peritonitis, asystole, lower extremity deep vein thrombosis, hydrothorax, acute liver failure, anasarca, polyserositis, ischemic cholangiopathy, common hepatic artery thrombosis, detachment of the common hepatic artery intima. We calculated a composite end point (the sum of all the complications).
Results: In 2 cases, there was an accidental decannulation of the cannula placed in the proper hepatic artery in the 30th minute of perfusion. Due to hemodynamic instability, the procedure was terminated. Death from worsening liver failure was reported in 3 cases. Postoperative bleeding was diagnosed in 7 patients, and relaparotomy was performed to stop the bleeding. Subsequently, no concerns were reported. The combined end point was 42.11%.
Conclusion: Isolated hepatic perfusion is an unsafe treatment option for patients with liver metastases of uveal melanoma.

Received 12 May 2023. Revised 16 June 2023. Accepted 21 June 2023.

Funding: The study did not have sponsorship.

Conflict of interest: The authors declare no conflict of interest.

Contribution of the authors
Conception and study design: A.D. Kaprin, Yu.V. Belov
Data collection and analysis: A.N. Kazantsev, V.M. Unguryan
Statistical analysis: A.N. Kazantsev, V.M. Unguryan, A.V. Korotkikh
Drafting the article: A.N. Kazantsev, V.M. Unguryan
Critical revision of the article: A.D. Kaprin, Yu.V. Belov, S.A. Ivanov
Final approval of the version to be published: V.M. Unguryan, A.N. Kazantsev, A.V. Korotkikh, S.A. Ivanov, Yu.V. Belov, A.D. Kaprin

pdf (Русский)

References

  1. Amaro A., Gangemi R., Piaggio F., Angelini G., Barisione G., Ferrini S., Pfeffer U. The biology of uveal melanoma. Cancer Metastasis Rev. 2017;36(1):109-140. PMID: 28229253; PMCID: PMC5385203. https://doi.org/10.1007/s10555-017-9663-3
  2. Aronow M.E., Topham A.K., Singh A.D. Uveal melanoma: 5-year update on incidence, treatment, and survival (SEER 1973-2013). Ocul Oncol Pathol. 2018;4(3):145-151. PMID: 29765944; PMCID: PMC5939716. https://doi.org/10.1159/000480640
  3. Каприн А.Д., Иванов С.А., Унгурян В.М., Петров Л.О., Побединцева Ю.А., Фалалеева Н.А., Филимонов Е.В., Круглов Е.А. Современные возможности применения изолированной химиоперфузии печени в лечении метастатической увеальной меланомы. Паллиативная медицина и реабилитация. 2021;4:5-10. Kaprin A.D., Ivanov S.A., Unguryan V.M., Petrov L.O., Pobedintseva Yu.A., Falaleeva N.A., Filimonov E.V., Kruglov E.A. Modern possibilities of using isolated liver chemoperfusion in the treatment of metastatic uveal melanoma. Palliativnaya meditsina i reabilitatsiya = Palliative Medicine and Rehabilitation. 2021;4:5-10. (In Russ.)
  4. Kaliki S., Shields C.L. Uveal melanoma: relatively rare but deadly cancer. Eye (Lond). 2017;31(2):241-257. PMID: 27911450; PMCID: PMC5306463. https://doi.org/10.1038/eye.2016.275
  5. Alexander H.R. Jr, Libutti S.K., Pingpank J.F., Steinberg S.M., Bartlett D.L., Helsabeck C., Beresneva T. Hyperthermic isolated hepatic perfusion using melphalan for patients with ocular melanoma metastatic to liver. Clin Cancer Res. 2003;9(17):6343-6349. PMID: 14695133.
  6. Shields C.L., Shields J.A. Ocular melanoma: relatively rare but requiring respect. Clin Dermatol. 2009;27(1):122-133. PMID: 19095158. https://doi.org/10.1016/j.clindermatol.2008.09.010
  7. Ulmer A., Beutel J., Süsskind D., Hilgers R.-D., Ziemssen F., Lüke M., Röcken M., Rohrbach M., Fierlbeck G., Bartz-Schmidt K.-U., Grisanti S. Visualization of circulating melanoma cells in peripheral blood of patients with primary uveal melanoma. Clin Cancer Res. 2008;14(14):4469-4474. PMID: 18628461. https://doi.org/10.1158/1078-0432.CCR-08-0012
  8. Саакян С.В., Пантелеева О.Г., Ширина Т.В. Особенности метастатического поражения и выживаемости больных с увеальной меланомой в зависимости от метода проведенного лечения. Российский офтальмологический журнал. 2012;5(2):55-58. Saakyan S.V., Panteleeva O.G., Shirina T.V. Metastatic disease characteristics and survival of patients with uveal melanoma depending on the method of treatment of the primary tumor. Russian Ophthalmological Journal. 2012;5(2):55-58. (In Russ.)
  9. Rowcroft A., Loveday B.P.T., Thomson B.N.J., Banting S., Knowles B. Systematic review of liver directed therapy for uveal melanoma hepatic metastases. HPB (Oxford). 2020;22(4):497-505. PMID: 31791894. https://doi.org/10.1016/j.hpb.2019.11.002
  10. Ben-Shabat I., Belgrano V., Ny L., Nilsson J., Lindnér P., Olofsson Bagge R. Long-term follow-up evaluation of 68 patients with uveal melanoma liver metastases treated with isolated hepatic perfusion. Ann Surg Oncol. 2016;23(4):1327-1334. PMID: 26628434. https://doi.org/10.1245/s10434-015-4982-5
  11. Yang X.-Y., Xie F., Tao R., Li A.-J., Wu M.-C. Treatment of liver metastases from uveal melanoma: a retrospective single-center analysis. Hepatobiliary Pancreat Dis Int. 2013;12(6):602-606. PMID: 24322745. https://doi.org/10.1016/s1499-3872(13)60095-8
  12. Ben-Shabat I., Belgrano V., Hansson C., Olofsson Bagge R. The effect of perfusate buffering on toxicity and response in isolated hepatic perfusion for uveal melanoma liver metastases. Int J Hyperthermia. 2017;33(4):483-488. PMID: 28110582. https://doi.org/10.1080/02656736.2017.1286046
  13. Alexander H.R. Jr, Bartlett D.L., Libutti S.K. Isolated hepatic perfusion: a potentially effective treatment for patients with metastatic or primary cancers confined to the liver. Cancer J Sci Am. 1998;4(1):2-11.