Traitement par chimioembolisation intra artérielle hépatique des métastases hépatiques de mélanomes uvéaux : étude rétrospective de 34 patients consécutifs

Abstract : Purpose: First description of the efficacy and safety of hepatic transarterial chemoembolization (TACE) using melphalan and microspheres in patients with liver metastasis from uveal melanoma (UM).
Materials and methods: Monocentric retrospective study from 2004 to 2016 including 34 consecutive patients with liver metastasis from ocular melanoma treated by TACE using melphalan and 250μm calibrated microspheres. Radiological response was assessed according to RECIST 1.1, mRECIST and EASL on contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI). The primary endpoint was the overall survival (OS). Liver metastasis response (LMR), hepatic, extrahepatic and global progression free survival (PFS), complications evaluated with the common terminology criteria for adverse events version 4.0 (CTCAE 4.0) and survival factors were secondary endpoints.
Results: The 34 patients underwent 138 TACE (4; 4.1 sessions; range 1-9) with a median OS of 16.5 months (mean 21.6 months). LMR combining partial and complete response was 42.4%, 97%, 97% with RECIST 1.1, mRECIST, EASL respectively. There were 58 major complications (CTCAE ≥ 3) in 28 patients including 1 death due to septic shock.
Conclusion: For patients with liver metastases from UM, the TACE using melphalan showed good results on OS comparatively to previous reports and good results on LMR with an acceptable rate of complications. This treatment seems to shift the prognosis for most of patients on other secondary locations.
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Master Thesis
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Xavier Carle. Traitement par chimioembolisation intra artérielle hépatique des métastases hépatiques de mélanomes uvéaux : étude rétrospective de 34 patients consécutifs. Médecine humaine et pathologie. 2018. ⟨dumas-01977469⟩

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