PERKÜTAN HEPATİK PERFÜZYON İLE KEMOSATURASYON İŞLEMİNİN ORTA-UZUN DÖNEM SONUÇLARININ DEĞERLENDİRİLMESİ
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Purpose: The aim of this study to evaluate technical specifications, efficacy, safety and impact on survival of chemosaturation with percutaneous hepatic perfusion in patients with liver metastasis in whom all the alternative treatments were failed. Material and Method: Three patients with hepatic metastasis who underwent percutaneous hepatic perfusion between March 2016 – February 2017 were included in this study. Two of the patients had uveal melanoma and other patient had colorectal carcinoma. Patient and treatment characteristics, clinical findings, imaging and laboratory results were evaluated. Results: Three patients had a total of six procedures with two for each. The technical success rate was 100% and the mean melphalan dose was 190.8 mg. No procedural death was observed. Patients were hospitalized for a mean of 3.3 days after procedures. Grade 3 and 4 complications were seen after 50% and 33.3% of procedures, respectively. Two patients showed partial response and other patient showed stable disease after procedures, and mean hepatic progression-free survival was 43 weeks. Overall survival from the first procedure was 63.6 weeks in our cohort. Conclusions: Our results show chemosaturation with PHP offers a promising minimally invasive treatment option in uveal melanoma or colorectal carcinoma patients with unresectable liver metastases. In our study, percutaneous hepatic perfusion had a survival of 63.8 weeks in salvage therapy of advanced stage metastatic disease which progressed after all other alternative treatments. It is a relatively safe procedure and its toxicities can be manageable with close surveillance and appropriate medical therapies.