Open AccessOver 12 Years Single Institutional Experience Performing Percutaneous Hepatic Perfusion for Unresectable Liver Metastases
Author(s) -
Michael J. Carr,
James Sun,
Jonathan Cohen,
Jinhong Liu,
Andrew A. Serdiuk,
S. Stewart,
Navin Doobay,
Andrew Duclos,
David A Seal,
Junsung Choi,
Jonathan S. Zager
Publication year - 2020
Publication title -
cancer control
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.794
H-Index - 72
eISSN - 1526-2359
pISSN - 1073-2748
DOI - 10.1177/1073274820983019
Subject(s) - medicine , percutaneous , melanoma , systemic therapy , surgical oncology , radiology , perfusion , chemotherapy , surgery , cancer , cancer research , breast cancer
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.