Isolated hepatic perfusion for metastases of uveal melanoma: hospital outcomes

Objective: To evaluate hospital outcomes of isolated hepatic perfusion for metastases of uveal melanoma. Methods: In 2020-2022, 38 isolated hepatic perfusion procedures for unresectable metastases of uveal melanoma were performed in the Kostroma Regional Cancer Center. Our study included the following complications: death, bleeding, tumor lysis syndrome, abscess in the left lobe of the liver, peritonitis, asystole, lower extremity deep vein thrombosis, hydrothorax, acute liver failure, anasarca, polyserositis, ischemic cholangiopathy, common hepatic artery thrombosis, detachment of the common hepatic artery intima. We calculated a composite end point (the sum of all the complications). Results: In 2 cases, there was an accidental decannulation of the cannula placed in the proper hepatic artery in the 30th minute of perfusion. Due to hemodynamic instability, the procedure was terminated. Death from worsening liver failure was reported in 3 cases. Postoperative bleeding was diagnosed in 7 patients, and relaparotomy was performed to stop the bleeding. Subsequently, no concerns were reported. The combined end point was 42.11%. Conclusion: Isolated hepatic perfusion is an unsafe treatment option for patients with liver metastases of uveal melanoma.