Hepatic arterial chemoembolization for management of metastatic melanoma

Karun V. Sharma, Jennifer E. Gould, J. William Harbour, Gerald P. Linette, Thomas K. Pilgram, Pouya N. Dayani, Daniel B. Brown

Research output: Contribution to journalArticle

56 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)99-104
Number of pages6
JournalAmerican Journal of Roentgenology
Volume190
Issue number1
DOIs
StatePublished - Jan 1 2008
Externally publishedYes

Fingerprint

Melanoma
Liver
Disease-Free Survival
Neoplasm Metastasis
Angiography
Survival
Survival Rate
Neoplasms
Therapeutics
Disease Progression
Skin

Keywords

  • Hepatic arterial chemoembolization
  • Liver
  • Metastasis
  • Metastatic disease
  • Ocular melanoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Sharma, K. V., Gould, J. E., William Harbour, J., Linette, G. P., Pilgram, T. K., Dayani, P. N., & Brown, D. B. (2008). Hepatic arterial chemoembolization for management of metastatic melanoma. American Journal of Roentgenology, 190(1), 99-104. https://doi.org/10.2214/AJR.07.2675

Hepatic arterial chemoembolization for management of metastatic melanoma. / Sharma, Karun V.; Gould, Jennifer E.; William Harbour, J.; Linette, Gerald P.; Pilgram, Thomas K.; Dayani, Pouya N.; Brown, Daniel B.

In: American Journal of Roentgenology, Vol. 190, No. 1, 01.01.2008, p. 99-104.

Research output: Contribution to journalArticle

Sharma, KV, Gould, JE, William Harbour, J, Linette, GP, Pilgram, TK, Dayani, PN & Brown, DB 2008, 'Hepatic arterial chemoembolization for management of metastatic melanoma', American Journal of Roentgenology, vol. 190, no. 1, pp. 99-104. https://doi.org/10.2214/AJR.07.2675
Sharma, Karun V. ; Gould, Jennifer E. ; William Harbour, J. ; Linette, Gerald P. ; Pilgram, Thomas K. ; Dayani, Pouya N. ; Brown, Daniel B. / Hepatic arterial chemoembolization for management of metastatic melanoma. In: American Journal of Roentgenology. 2008 ; Vol. 190, No. 1. pp. 99-104.
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AB - 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.

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