Karydis I, Gangi A, Wheater MJ, et al. Percutaneous hepatic perfusion with melphalan in uveal melanoma: A safe and effective treatment modality in an orphan disease. J Surg Oncol. 2018 May;117(6):1170-1178.
Figure 1. Melphalan percutaneous hepatic perfusion (M-PHP) circuit.
Results: A total of 51 patients received 134 M‐PHP procedures (median of 2 M‐PHPs). 25 (49%) achieved a partial (N = 22, 43.1%) or complete hepatic response (N = 3, 5.9%). In 17 (33.3%) additional patients, the disease stabilized for at least 3 months, for a hepatic disease control rate of 82.4%. After median follow‐up of 367 days, median overall progression free (PFS) and hepatic progression free survival (hPFS) was 8.1 and 9.1 months, respectively and median overall survival was 15.3 months. There were no treatment related fatalities. Non‐hematologic grade 3‐4 events were seen in 19 (37.5%) patients and were mainly coagulopathic (N = 8) and cardiovascular (N = 9).
Conclusions: M‐PHP results in durable intrahepatic disease control and can form the basis for an integrated multimodality treatment approach in appropriately selected UM patients.
de Leede EM, et al. Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver. J Vis Exp. 2016 Jul 31;(113):53795.
View procedural video.
“The current status of PHP in treating hepatic malignancies is not yet settled, but a recently published phase III trial showed improved progression free survival. Future trials will also have to prove whether PHP can be integrated in treatment strategy for other types of malignancies. The short hospital stay after the procedure, indicating the tolerability of this procedure, and the manageable complications supports ongoing research of PHP in the treatment of cancer confined to the liver.
In summary, PHP is a well-tolerated local therapy for patients with unresectable liver metastases. Survival and duration of response are investigated in various trials.”
More PubMed results on PHP.
Surgical Focus 