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AJR Am J Roentgenol. 2008 Jan;190(1):99-104.

Hepatic arterial chemoembolization for management of metastatic melanoma.

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1
Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA.

Abstract

OBJECTIVE:

Hepatic arterial chemoembolization is an accepted therapy for stage 4 melanoma with liver-dominant metastasis. However, the reports of outcomes are limited. We present our outcomes with hepatic arterial chemoembolization for metastasis of stage 4 melanoma.

MATERIALS AND METHODS:

Twenty patients with liver-dominant metastasis of ocular or cutaneous melanoma were treated with hepatic arterial chemoembolization. Overall survival and progression-free survival rates were calculated from the first treatment. Patients with intrahepatic tumor progression were treated with additional hepatic arterial chemoembolization. Both overall survival and progression-free survival were analyzed with the Kaplan-Meier method. Tumor pattern on angiography was characterized as either nodular or infiltrative on the basis of angiographic appearance.

RESULTS:

The 20 patients underwent 46 hepatic arterial chemoembolization sessions (mean, 2.4 sessions; range, 1-5). The mean and median overall survival times were 334 +/- 71 and 271 days, respectively. There were no deaths within 30 days of treatment. Thirteen of the 20 patients had progression of disease. The mean and median progression-free survival times for these patients were 231 +/- 42 and 185 days, respectively. Patients with lesions that had a nodular angiographic appearance had longer progression-free survival than patients with lesions that had an infiltrative appearance (mean progression-free survival time, 249 vs 63 days). Patients with lesions that had a nodular angiographic appearance also survived significantly longer than those with lesions that had an infiltrative angiographic pattern (mean overall survival time, 621 vs 114 days; p = 0.0002).

CONCLUSION:

Hepatic arterial chemoembolization for liver-dominant metastasis of stage 4 melanoma is a safe treatment that results in longer survival than has occurred among historical controls. Patients with lesions that have a nodular tumor appearance on angiography survive significantly longer than patients with lesions that have an infiltrative appearance on angiography.

PMID:
18094299
DOI:
10.2214/AJR.07.2675
[Indexed for MEDLINE]
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