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Hepatic arterial Fotemustine chemotherapy in patients with liver metastases from cutaneous melanoma is as effective as in ocular melanoma

Item Type:Article
Title:Hepatic arterial Fotemustine chemotherapy in patients with liver metastases from cutaneous melanoma is as effective as in ocular melanoma
Creators Name:Siegel, R. and Hauschild, A. and Kettelhack, C. and Kaehler, K.C. and Bembenek, A. and Schlag, P.M.
Abstract:AIM: Hepatic metastases from melanoma are associated with poor prognosis. Systemic chemotherapy and biological treatments remain unsatisfactory. This study investigated the impact of hepatic arterial chemotherapy in patients with ocular and cutaneous melanoma. METHODS: In a retrospectively analysed observational study, 36 consecutive patients with hepatic metastases from ocular or cutaneous melanoma were assigned for surgical hepatic port-catheter implantation. Fotemustine was delivered weekly for a 4-week period, followed by a 5-week rest and a maintenance period every 3weeks until progression. Overall survival, response and toxicity were analysed and compared. RESULTS: After port-catheter implantation 30/36 patients were finally treated (18 with ocular and 12 with cutaneous melanoma). A median of 8 infusions per patient were delivered (range 3-24). 30% thrombocytopenia grade >/=3, 7% neutropenia grade >/=3 but no nausea or vomiting grade >/=3 were encountered. Nine out of 30 patients achieved partial remission, 10/30 stable disease; 11/30 patients were progressive. Median survival for all treated patients was 14months. Partial remission and stable disease were associated with a survival advantage compared to progressive disease (19 vs. 5months). No significant difference in survival was observed for ocular versus cutaneous melanoma. Serum LDH was a significant predictor of both response and survival. CONCLUSIONS: Hepatic arterial Fotemustine chemotherapy was well tolerated. Meaningful response and survival rates were achieved in ocular as well as cutaneous melanoma. Careful patient selection in consideration of extra-hepatic involvement is crucial for the effectiveness of this treatment. Independent from the primary melanoma site, it is debatable if patients with highly elevated serum-LDH may benefit from this approach.
Keywords:Hepatic arterial therapy, Fotemustine, Liver metastasis, Cutaneous melanoma, Ocular melanoma
Source:European Journal of Surgical Oncology
ISSN:0748-7983
Publisher:Elsevier (The Netherlands)
Volume:33
Number:5
Page Range:627-632
Date:June 2007
Official Publication:https://doi.org/10.1016/j.ejso.2006.11.019
PubMed:View item in PubMed

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