This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Oncology  • Oncology, Other  • Ocular/ Adnexal Tumors  • Radiologic Imaging  • Prognosis/ Outcomes  • Liver/ Biliary Tract/ Pancreatic Diseases  • Alert me on articles by topic  Social Bookmarking   What's this?

Angiographic Pattern Predictive of Survival After Hepatic Arterial Chemoembolization

Pouya N. Dayani, MD; Jennifer E. Gould, MD; Daniel B. Brown, MD; Karun V. Sharma, MD; Gerald P. Linette, MD; J. William Harbour, MD

Arch Ophthalmol. 2009;127(5):628-632.

Objective  To identify clinical features associated with survival after hepatic arterial chemoembolization (HACE) for uveal melanoma metastasis.

Methods  Retrospective case series including 11 men and 10 women with uveal melanoma metastasis.

Results  The hepatic angiographic pattern of metastasis was infiltrative in 12 patients (57%) and nodular in 9 patients (43%). The infiltrative pattern was associated with ciliary body involvement by the primary tumor (Fisher exact test, P = .01) and extrascleral tumor extension (Fisher exact test, P = .01). Mean survival after the first HACE treatment was 7.6 months overall, 3.7 months for the patients with the infiltrative pattern, and 12.7 months for those with the nodular pattern. This difference was highly significant (Kaplan-Meier, P < .001). Chromosome 8p was found to be deleted in 4 patients with the infiltrative pattern and in no patients with the nodular pattern.

Conclusions  The hepatic metastasis pattern can be used to predict response to and survival after HACE. Loss of chromosome 8p may be a biomarker for the infiltrative metastasis pattern. Hepatic arterial chemoembolization may play an important role in the treatment of hepatic metastasis from uveal melanoma in patients with the nodular metastatic pattern. Regular screening for hepatic metastasis in patients with uveal melanoma may be beneficial in identifying those who would benefit from HACE.

Author Affiliations: Departments of Ophthalmology and Visual Sciences (Drs Dayani and Harbour) and Radiology (Drs Gould, Brown, and Sharma) and the Siteman Cancer Center (Dr Linette), Washington University School of Medicine, St Louis, Missouri.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?