Chemosaturation with Percutaneous Hepatic Perfusion in Unresectable Hepatic Metastases

Glazer, Evan S.; Zager, Jonathan S.

doi:10.1177/107327481702400116

Cited by 11 publications

(10 citation statements)

References 15 publications

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“…An ORR of 47% has been observed for the treatment of metastatic uveal melanoma, cutaneous melanoma, sarcoma, breast cancer and cholangiocarcinoma. 6,[33][34][35][36][37] Severe AEs ( grade 3) including liver failure are infrequent, and the procedure can be repeated up to 6 times. Although no direct comparison exists between the different treatment methods for hepatic metastasis, one retrospective study which evaluated the outcomes of metastatic cutaneous and uveal melanoma found significantly prolonged hepatic progression free survival (PFS), overall PFS, and OS in patients treated with PHP versus Yttrium-90 and chemoembolization.…”

Section: Treatment Of Unresectable Melanoma Hepatic Metastasesmentioning

confidence: 99%

Over 12 Years Single Institutional Experience Performing Percutaneous Hepatic Perfusion for Unresectable Liver Metastases

et al. 2020

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Patients with unresectable hepatic metastases, from uveal or ocular melanoma, are challenging to treat with an overall poor prognosis. Although over the past decade significant advances in systemic therapies have been made, metastatic disease to the liver, especially from uveal melanoma, continues to be a poor prognosis. Percutaneous hepatic perfusion (PHP) is a safe, viable treatment option for these patients. PHP utilizes high dose chemotherapy delivered directly to the liver while minimizing systemic exposure and can be repeated up to 6 times. Isolation of the hepatic vasculature with a double-balloon catheter allows for high concentration cytotoxic therapy to be administered with minimal systemic adverse effects. A detailed description of the multidisciplinary treatment protocol used at an institution with over 12 years of experience is discussed and recommendations are given. A dedicated team of a surgical or medical oncology, interventional radiology, anesthesiology and a perfusionist allows PHP to be repeatedly performed as a safe treatment strategy for unresectable hepatic metastases.

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Section: Treatment Of Unresectable Melanoma Hepatic Metastasesmentioning

confidence: 99%

Over 12 Years Single Institutional Experience Performing Percutaneous Hepatic Perfusion for Unresectable Liver Metastases

et al. 2020

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“…Worldwide, CS-PHP has traditionally been performed with access via the femoral artery [ 2 - 3 ]. To our knowledge, the cases presented are the first reported uses of the radial artery for hepatic chemosaturation.…”

Section: Discussionmentioning

confidence: 99%

“…Chemosaturation with percutaneous hepatic perfusion (CS-PHP; Hepatic CHEMOSAT® Delivery System; Delcath Systems Inc, Wilmington, Delaware) is an interventional radiology procedure that delivers high doses of melphalan directly to the liver in patients with unresectable primary and secondary liver tumours [ 1 ]. The most common primary malignancy treated is ocular melanoma, though reports of treatment for colorectal cancer, cutaneous melanoma and breast cancer also exist [ 2 ]. Hepatic response rates by Response Evaluation Criteria in Solid Tumors (RECIST) criteria (assessment of tumour shrinkage) tend to vary, with studies quoting figures from 58-75% [ 3 ], though response rates to uveal melanoma alone have been reported up to 83% [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Radial Artery Access for Hepatic Chemosaturation: The First Description of Technical Feasibility

Frost

Najran

Bell

et al. 2021

Cureus

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Chemosaturation with percutaneous hepatic perfusion (CS-PHP; Hepatic CHEMOSAT® Delivery System, Delcath Systems Inc, Wilmington, Delaware) is an interventional radiology procedure that delivers high doses of melphalan, a chemotherapeutic agent, directly to the liver in patients with unresectable primary and secondary liver tumours. Traditionally, CS-PHP is delivered by arterial access via the femoral artery. However, there can be many risks and adverse effects associated with femoral artery punctures, such as retroperitoneal haemorrhage and haematoma formation. The monitoring and bed rest required following the removal of a femoral arterial catheter may also cause significant distress to patients as they remain immobile, potentially prolonging their stay in hospital. The radial artery is an alternative access point, with fewer reported adverse events and increased patient tolerance when compared with femoral access. This case report details the first reported use of Hepatic CHEMOSAT® therapy being delivered via the radial artery. Two patients received hepatic chemosaturation with no reported complications. This report demonstrates that access via the radial artery is a feasible alternative for the delivery of chemotherapy, which may reduce morbidity and the risks usually associated with femoral access.

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“…IHP with melphalan has emerged as a viable treatment option for ocular melanoma, with up to 70% of patients demonstrating treatment response and median overall survival extending from 10 to 24 months . Minimally invasive percutaneous approaches to hepatic perfusion have also been developed to minimize perioperative morbidity with encouraging results . Percutaneous hepatic perfusion (PHP) utilizes percutaneously placed catheters to achieve vascular control of the liver and deliver the drug to the isolated liver in a similar fashion to the open approach while sparing the morbidity associated with a laparotomy and portal dissection.…”

Section: Discussionmentioning

confidence: 99%

Hepatic artery infusion of melphalan in patients with liver metastases from ocular melanoma

Boone

Perkins

Bandi

et al. 2018

Journal of Surgical Oncology

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Chemosaturation with Percutaneous Hepatic Perfusion in Unresectable Hepatic Metastases

Cited by 11 publications

References 15 publications

Over 12 Years Single Institutional Experience Performing Percutaneous Hepatic Perfusion for Unresectable Liver Metastases

Over 12 Years Single Institutional Experience Performing Percutaneous Hepatic Perfusion for Unresectable Liver Metastases

Radial Artery Access for Hepatic Chemosaturation: The First Description of Technical Feasibility

Hepatic artery infusion of melphalan in patients with liver metastases from ocular melanoma

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