Meta-Analysis of Isolated Hepatic Perfusion and Percutaneous Hepatic Perfusion as a Treatment for Uveal Melanoma Liver Metastases.
Meta-Analysis of Isolated Hepatic Perfusion and Percutaneous Hepatic Perfusion as a Treatment for Uveal Melanoma Liver Metastases.
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DOI：
10.3390/cancers13184726
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发表时间：
2021-09-21
期刊：
影响因子：
5.2
通讯作者：
Olofsson Bagge R
中科院分区：
文献类型：
--
作者：
Bethlehem MS;Katsarelias D;Olofsson Bagge R
隔离肝灌注是葡萄膜黑色素瘤肝转移患者的一种有效治疗选择。这是一种开放式外科手术，其中肝脏与循环分离并灌注化疗剂。现代发展是微创经皮肝灌注，其中肝脏被血管内隔离，然后通过动脉系统中的导管用化疗剂灌注。在本系统综述和荟萃分析中，我们的目的是在总生存期、无进展生存期、并发症和反应方面比较这些模式。背景资料：葡萄膜黑色素瘤是成人中最常见的原发性眼内恶性肿瘤，患者发生转移性疾病的风险很高，主要发生在肝脏。美法仑隔离肝灌注（IHP）是一种针对肝转移患者的肝脏治疗方法。经皮肝灌注（PHP），一种微创技术，也是可用的。PHP的好处在于，该过程可以重复，因此可能提供更好的生存率。我们对这两种技术进行了系统回顾和荟萃分析。方法：采用Scopus、MEDLINE、Web of Science、PubMed和科克伦中心数据库进行系统文献检索。分析中共纳入了9篇报告8项研究的文章。从每项研究中提取个体生存数据。结果：IHP组中位总生存期（OS）为17.1个月，PHP组为17.3个月。IHP的中位无进展生存期（PFS）为7.2个月，PHP为9.6个月。IHP的中位肝脏无进展生存期为10个月，PHP为9.5个月。IHP组的并发症发生率和30天死亡率分别为39.1%和5.5%，PHP组为23.8%和1.8%。结论：对于葡萄膜黑色素瘤肝转移患者，IHP和PHP之间的OS或PFS没有差异，但患者在PHP后并发症和死亡率的风险显著降低。
Isolated hepatic perfusion is one of the available treatment options for patients with liver metastases from uveal melanoma. This is an open surgical procedure where the liver is isolated from the circulation and perfused with a chemotherapeutic agent. A modern development is the minimally invasive percutaneous hepatic perfusion, where the liver is endovascularly isolated and then perfused with a chemotherapeutic agent through a catheter in the arterial system. Within this systematic review and meta-analysis, we aim to compare these modalities in terms of overall survival, progression-free survival, complications and response. Background: Uveal melanoma is the most commonly occurring primary intraocular malignancy in adults, and patients have a high risk of developing metastatic disease, mostly in the liver. Isolated hepatic perfusion (IHP) with melphalan is a liver-directed therapy for patients with liver metastases. Percutaneous hepatic perfusion (PHP), a minimally invasive technique, is available as well. PHP benefits from the fact that the procedure can be repeated and therefore possibly offers better survival. We conducted a systematic review and meta-analysis comparing both techniques. Methods: A systematic literature search was performed using the electronic databases of Scopus, MEDLINE, Web of Science, PubMed and Cochrane CENTRAL. A total of nine articles reporting on eight studies were included in the analysis. Individual survival data were extracted from each study. Results: The median overall survival (OS) was 17.1 months for IHP and 17.3 months for PHP. The median progression-free survival (PFS) was 7.2 months for IHP and 9.6 months for PHP. The median hepatic progression-free survival was 10 months for IHP and 9.5 months for PHP. The complication rate and 30-day mortality rate were 39.1% and 5.5% for IHP and 23.8% and 1.8% for PHP. Conclusion: There was no difference in OS or PFS between IHP and PHP for patients with uveal melanoma liver metastases, but patients have significantly less of a risk for complications and mortality following PHP.
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影响因子：
8.4
作者：
Eisenhauer, E. A.;Therasse, P.;Verweij, J.
通讯作者：
Verweij, J.
影响因子：
1.2
作者：
Ben-Shabat, Ilan;Hansson, Christoffer;Bagge, Roger Olofsson
通讯作者：
Bagge, Roger Olofsson
影响因子：
10.9
作者：
Heppt, Markus, V;Amaral, Teresa;Berking, Carola
通讯作者：
Berking, Carola
DOI：
10.1055/a-1348-1932
发表时间：
2021-02-03
影响因子：
1.8
作者：
Dewald, Cornelia Lieselotte Angelika;Hinrichs, Jan B.;Wacker, Frank K.
通讯作者：
Wacker, Frank K.
紫veal瘤的转移性疾病：治疗选择和未来前景。
DOI：
10.1136/bjophthalmol-2016-309034
发表时间：
2017-01
期刊：
The British journal of ophthalmology
影响因子：
--
作者：
Carvajal RD;Schwartz GK;Tezel T;Marr B;Francis JH;Nathan PD
通讯作者：
Nathan PD