Surgical resection plus biotherapy/chemotherapy improves survival of hepatic metastatic melanoma

AIM: To analyze the correlation of treatment method with the outcome of all the hepatic metastatic mela-noma (HMM) patients from our hospital.METHODS: There were altogether nine cases of HMM that had been treated in the PUMCH hospital during the past 25 years, from December 1984 to February 2010. Al...

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Published in:World journal of hepatology 2012-11, Vol.4 (11), p.305-310
Main Authors: Du, Shun-Da, Mao, Yi-Lei, Li, Shao-Hua, Sang, Xin-Ting, Lu, Xin, Xu, Yi-Yao, Xu, Hai-Feng, Zhao, Lin, Bai, Chun-Mei, Zhong, Shou-Xian, Huang, Jie-Fu
Format: Article
Language:English
Subjects:
Biotherapy
Brief
Chemotherapy
Hepatectomy
Hepatic
Malignant
melanoma
metastatic
Prognosis
tumor
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Summary:AIM: To analyze the correlation of treatment method with the outcome of all the hepatic metastatic mela-noma (HMM) patients from our hospital.METHODS: There were altogether nine cases of HMM that had been treated in the PUMCH hospital during the past 25 years, from December 1984 to February 2010. All of the cases developed hepatic metastasis from primary cutaneous melanoma. A retrospective review was performed on all the cases in order to draw informative conclusion on diagnosis and treatment in correlation with the prognosis. Clinical features including symptoms, signs, blood test results, Bultrasound and computed tomography (CT) imaging characteristics, and pathological data were analyzed in each case individually. A simple comparison was made on case by case basis instead of performing statistical analysis since the case numbers are low and patients were much diversified in each item that has been analyzed. Literatures on this subject were reviewed in order to draw a safe conclusion and found to be supportive to our finding in a much broad scope. RESULTS: There are six males and three females whose ages ranged 39-74 years old with an average of 58.8. Patients were either with or without symptoms at the time of diagnosis. The liver function and tumor marker exam were normal in all but one patient. The incidence of HMM does not affect liver function and was not related to virus infection status in the liver. Most of these HMM patients were also accompanied by the metastases of other locations, including lung, abdominal cavity, and cervical lymph nodes. Ultra-sound examinations showed lesions ranging 2-12 cm in diameter, with noor low-echo peripheral areola. Doppler showed blood flow appeared inside some tumors as well as in the surrounding area. CT image demonstrated low density without uniformed lesions, characterized with calcification in periphery, and en-hanced in the arterial phase. Contrast phase showed heterogeneous enhancement, with a density higher than normal liver tissue, which was especially appar-ent at the edge. Patients were treated differently with following procedures: patients #1, #6 and #8 were operated with hepatectomy with or without removal of primary lesion, and followed by comprehensive biotherapy/chemotherapy; patient #9 received hepatectomy only; patient #2 received bacille calmette-guerin treatment only; patient #7 had Mile’s surgery but no hepatectomy; and patients #3, #4 and #5 had supportive treatment without specific measure
ISSN:1948-5182
1948-5182
DOI:10.4254/wjh.v4.i11.305