Unresectable Intrahepatic Cholangiocarcinoma: Retrospective Clinical Trial of Percutaneous Hepatic Perfusion (PHP-M) with Melphalan

Schneider MA1#, Warnke MM1#, Tiede M1, Reese T2, Wohlmuth P3, Hoedtke J4, Weilert H5, Stang A5,6, Oldhafer K2,6 and Brüning R1*

1Department of Radiology and Neuroradiology, Asklepios Hospital Barmbek, Germany
2Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, Asklepios Hospital Barmbek, Germany
3Department of Biostatistics, ProResearch, Lohmuehlenstrasse 5, 20099, Germany
4Department of Anesthesiology, Asklepios Hospital Barmbek, Germany
5Department of Oncology, Asklepios Hospital Barmbek, Germany
6Semmelweis University of Medicine, Asklepios Campus Hamburg, Germany
#These authors contributed equally to this work

^*Correspondance to: Roland Brüning 

 PDF  Full Text DOI: 10.25107/2474-1647.3587

Abstract

Background: Unresectable intrahepatic Cholangiocarcinoma (iCC) has a poor overall prognosis and there is no established second line therapy. The purpose of this pilot study was to evaluate the efficacy of Percutaneous Hepatic Perfusion with high dose Melphalan (PHP-M) as second/last line therapy in patients with advanced or recurrent iCC. Methods: In this single center approach we retrospectively analyzed 10 patients (mean age 59 Standard Deviation (SD) 10 years) with advanced iCC with PHP-M in a standardized protocol. Overall Survival (OS) from initial diagnosis and from first PHP-M were analyzed. Adverse Effects (AE) were graded by Clavien Dindo and by the CIRSE classification. Results: Median OS was 26.3 months from initial diagnosis (SD 13.3 month) and 13.7 months (SD 7.0 month) from first PHP-M. The patients had an average tumor load of 263.8 ml (SD 241.7 ml) and were treated with 21 PHP-Ms in total. Tumor load after the first cycle of PHP-M treatment was reduced to 241.7 ml (SD 268.5 ml), and disease control by RECIST 1.1. was achieved in 7/10. No AEs of grade 4 Clavien Dindo or higher occurred during the procedures. Conclusion: PHP-M can be a safe and feasible therapy for patients with advanced iCC as a last line therapy.

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Cite the article

Schneider MA, Warnke MM, Tiede M, Reese T, Wohlmuth P, Hoedtke J, et al. Unresectable Intrahepatic Cholangiocarcinoma: Retrospective Clinical Trial of Percutaneous Hepatic Perfusion (PHP-M) with Melphalan. Clin Surg. 2022; 7: 3587..