Lactate Dehydrogenase Prior to Transarterial Hepatic Chemoperfusion Predicts Survival and Time to Progression in Patients with Uveal Melanoma Liver Metastases.
| Autor: | Ludwig J; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany., Haubold J; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany., Heusner TA; Clinic for Diagnostic and Interventional Radiology/Neuroradiology, Sankt-Elisabeth-Hospital Gütersloh, Gütersloh, Germany., Bauer S; West German Cancer Center, University Hospital Essen, Germany., Siveke JT; German Consortium for Translational Cancer Research (DKTK), partner location University Hospital Essen, University Hospital Essen, Germany., Richly H; West German Cancer Center, University Hospital Essen, Germany., Wetter A; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany., Umutlu L; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany., Theysohn JM; Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Germany. |
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| Jazyk: | angličtina |
| Zdroj: | RoFo : Fortschritte auf dem Gebiete der Rontgenstrahlen und der Nuklearmedizin [Rofo] 2021 Jun; Vol. 193 (6), pp. 683-691. Date of Electronic Publication: 2020 Dec 21. |
| DOI: | 10.1055/a-1299-1627 |
| Abstrakt: | Purpose: To assess serum lactate dehydrogenase (LDH) as a pretreatment prognostic factor in patients with uveal melanoma liver metastases treated with transarterial hepatic chemoperfusion (THC). Materials and Methods: 56 patients (48 % male, median age: 63.5 years) underwent a median of 4 THC sessions. Kaplan-Meier for median overall survival (OS) and time to hepatic progression (TTP; 95 %CI) in months and Cox proportional hazards model for uni- (UVA) & multivariate analyses (MVA) for hazard ratio (HR) evaluation were calculated. Results: The median OS was 9.4 months. The pretreatment LDH value before 1st THC was the strongest OS predictor with 19.8 months for normal (≦ 280 units per liter (U/L)), 9.7 for intermediate (> 280-< 1000 U/L), and 3.84 months for high (≧ 1000 U/L) LDH. LDH significantly predicted a median TTP with 8 months, 4 months, and 1 month for normal, intermediate, and high LDH, respectively. UVA revealed intermediate (16.5) and high (77.3) LDH, bilirubin > the upper limit of normal (ULN) (2.89), alkaline phosphatase > 1.5 ULN (6.8), leukocytes > ULN (4.2), gamma-glutamyl transferase (GGT) > ULN (7), extrahepatic metastases (1.8) and liver lesions ≥ 5 cm (3.6) as significant predictors for worse OS. MVA confirmed intermediate (5) and high (27.1) LDH, bilirubin (5.7), GGT (2.9), and tumor size ≥ 5 cm (3.7) as significant independent predictors for worse OS. Patients with decreasing vs. increasing LDH > 10 % between 1st and 2nd THC (median: 38 days) survived longer (14.6 vs. 4.3 months) and progressed later (7 months vs. 1 month). Conclusion: Elevated pretreatment serum LDH is an essential and robust OS and TTP predictor, potentially allowing for the identification of patients benefiting most from transarterial hepatic chemoperfusion. Key Points: · Pretherapeutic LDH is the most reliable prognosticator for OS and TTP. · Therapy-related LDH decrease > 10 % between 1st and 2nd THC had prolonged OS and TTP. · Lower Values of LDH, bilirubin, gamma-glutamyl transferase, and tumor size are independent pretherapeutic predictors for longer OS. · Extrahepatic metastases do not have an independent influence on overall survival. Citation Format: · Ludwig J, Haubold J, Heusner T et al. Lactate Dehydrogenase Prior to Transarterial Hepatic Chemoperfusion Predicts Survival and Time to Progression in Patients with Uveal Melanoma Liver Metastases. Fortschr Röntgenstr 2021; 193: 683 - 691. Competing Interests: The authors declare that they have no conflict of interest. (Thieme. All rights reserved.) |
| Databáze: | MEDLINE |
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