Combined treatment of uveal melanoma liver metastases.

Uveal melanoma (UM) is the most prevalent intraocular malignant tumor in the Western world. The prognosis of survival in the presence of metastatic disease is 2-7 months, depending on the treatment applied. - This article presents a case of metastatic UM with successful complex treatment of liver metastases. - A 49-year old female, underwent removal of the right eyeball in 1996 due to a histologically confirmed uveal melanoma. After 11 years, CT revealed a mass in the left kidney and multiple metastases in the liver. After left nephrectomy, 6 chemotherapy courses with dacarbazine were performed. The increasing liver metastases were observed. Additional 4 intraarterial (i/a) chemotherapy courses were administered using cisplatin, doxorubicin, fluorouracil, and interferon alfa. After few courses increase in CTC Grade 4 liver transaminases was seen. A partial response was observed, and in December 2008 the patient underwent surgery removing all liver metastases by 7 wedge or atypical resections. All margins were tumor-free. 21 months after liver resections and 14 years since dia?gnosis, the patient is alive without evidence of disease. - Successful treatment of metastatic uveal melanoma was due to a timely application of a combination of several treatment methods and good prognostic factors of the patient.

Effect of different treatment methods on survival in patients with pancreatic cancer.

PURPOSE: To assess the benefit of treatment modalities on the survival in patients with pancreatic cancer. MATERIAL AND METHODS: Eighty-five patients with pancreatic cancer were treated by surgery, radiotherapy, chemotherapy and combined therapy. The data was reviewed retrospectively and the benefit of various treatment methods to the median survival time of the patients was assessed. RESULTS: Median survival time of the patients diagnosed with local disease treated by radical resection and adjuvant treatment was 21.5 months; with radical resection only--12.6 months (p = 0.6). In patients with locally advanced disease and treated by radical resection and adjuvant therapies the median survival time was 12.1 months and by radical resection only 7.7 months (p = 0.6). For patients treated by palliative surgery, chemotherapy and radiotherapy median survival was 8.8 months and by palliative surgery alone 1.8 month (p = 0.015). 1-year actual survival of patients treated with radical resection and adjuvant therapies was 11.7%. For patients with radical resection only--10.5%. 3-year actual survival for the same groups of patients was 3.5% and 2.3%, respectively. 1-year actual survival of patients treated by palliative methods was 2.3%. CONCLUSIONS: Surgery with adjuvant treatment seems to be beneficial for pancreatic adenocarcinoma patients. In locally advanced and metastatic pancreatic cancer palliative chemotherapy or radiotherapy statistically significantly improved survival.