肝转移性眼底恶性黑素瘤的治疗探讨(附5例剖腹探查经验)

目的 探讨肝脏转移性黑素瘤手术切除的指征和可行性.方法和结果 回顾2005年1月至2010年12月期间在我院行剖腹探查的5例肝脏转移性恶性黑素瘤患者的临床资料,并结合文献进行分析.5例眼底恶性黑素瘤转移至肝脏的患者,均行激进性手术治疗,术中发现腹腔和肝脏多发转移1例(仅行剖腹探查、肝脏活检术),肝内多发病灶4例(均行姑息性肝脏转移病灶切除术).3例患者同期行围术期肝动脉栓塞化疗治疗.5例患者的预后均不佳,术后的平均生存时间为9.6(3～26)个月.结论 肝脏转移性眼底恶性黑素瘤无法早期发现,且手术指征不明,预后较差,仍是临床上的一项治疗难题.

Resection of liver metastases from ocular melanoma remains discussional: an experience with 5 cases

ObjectiveTo investigate the indications and feasibility of resecting liver metastases from ocular melanoma. Methods and ResultsFrom Jan. 2005 to Dec. 2010, 5 patients with liver metastases from ocular melanoma were admitted to our hospital and received abdominal exploration. The clinicopathologic features and the surgical results of the 5 patients were retrospectively analyzed together with the latest literatures home and abroad. All the 5 patients received aggressive surgical managements, and simultaneous intra-arterial hepatic chemoembolization (TACE) was done in three cases. One patient received liver biopsies only after discovery of multiple visceral metastases; the other 4 with multiple liver metastases underwent palliative liver resection. All the 5 patients had poor prognoses, with a median overall postoperative survival rate of 9.6 (3-26) months. ConclusionLiver metastases from ocular melanoma are impossible to detect in an early stage. With unclear surgical indications and poor prognosis, it remains hard to handle in clinical practice.