Imágenes en Radiología Intervencionista Acceso abierto


Retrospective Analysis of Patients Treated with Minimally Invasive Therapies to Control Hepatic Metastases from Choroidal Melanoma

Franklin Wilson Caires Gois*

Introduction: Some rarer types of melanoma include uveal melanoma, which arises from the uveal tract in the eye. This type of neoplasm accounts for about 5% of melanoma cases. It is the most common intraocular tumor in adults and has a different clinical and evolutionary course from cases of cutaneous melanoma, with special involvement of the liver. About 50% of patients diagnosed with uveal melanoma develop isolated liver metastases with a median survival of 2 months-7 months.

Materials and methods: This work is a retrospective, unicentric cohort study. It was submitted and approved by the research ethics committee. The radiological response, adverse effects and complications of the treatment modalities performed were evaluated.

Results: 16 patients were treated with either hepatic embolization or intra-arterial chemotherapy. The mean age of patients was 65 years with diagnosis at 56 years. 10 patients were female and 6 were male. 15 patients had primary Choroidal melanoma and 1 patient had cutaneous melanoma. 68% of patients were initially treated with brachytherapy and 25% with enucleating.

Discussion: This study has several limitations in statistical terms, mainly considering the small number of cases analyzed. There were also difficulties in extracting all the necessary data in an ideal way due to the omission of some information in the medical records and also the lack of some control exams for different reasons.

Conclusion: Twenty-three cycles of fotemustine treatment were performed, divided into induction and maintenance phases. The group of patients treated with fotemustine had more extensive disease with a consequent higher number of toxic complications when compared to embolization. To measure the degree of complication related to the procedures, the guideline of the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) was used.