Systematic Reviews
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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Oct 26, 2016; 4(5): 105-117
Published online Oct 26, 2016. doi: 10.13105/wjma.v4.i5.105
Table 1 Summary of data points presented in relevant clinical trials
Ref .Year Country Research institution Study period MINORS score IHP patients (n ) Tumor details Eligibility and exclusion criteria IHP details and response rate Morbidity and mortality Complications and toxicities Long-term survival Prognostic factors Olofsson et al [55 ] 2014 Sweden The Swedish National Board of Health and Welfare April 2005 to March 2011 18 34 Y Y Y Y Y Y Y Magge et al [56 ] 2014 United States University of Pittsburgh Cancer Institute November 2003 to February 2012 12 91 Y NR Y Y Y Y Y Fukumoto et al [57 ] 2014 Japan The Kobe University Hospital January 1989 to December 2010 12 68 Y Y Y NR Y Y Y Alexander et al [58 ] 2009 United States NCI June 1994 to July 2005 12 120 Y Y Y Y Y Y Y van Iersel et al [59 ] 2008 Netherlands Leiden University Medical Center August 1994 to December 2004 12 105 Y Y Y Y Y Y Y Rizell et al [60 ] 2008 Sweden Sahlgrenska University Hospital 1985 to 2007 11 27 Y Y Y Y Y Y NR Pingpank et al [61 ] 2005 United States NCI July 2001 to January 2004 12 28 Y Y Y Y Y NR NR Alexander et al [62 ] 2003 United States NCI December 1997 to August 2002 12 29 Y Y Y Y Y Y Y
Table 2 Patient demographics and disease characteristics
Ref .Patients (n ) Age (median) Male: Female Primary tumor Primary tumor treatment n (%)Liver involvement n (%) or mean percentage (range) Number of liver metastases Largest liver metastases diameter (cm), median (range) Extra-hepatic metastases n (%) Excision Chemotherapy No treatment < 5% 25%-0% > 0% Olofsson et al [55 ] 34 61 (17-77) 15:19 Ocular melanoma 15 (44%) 19 (56%) None 31 (91%) 3 (9%) None 1-100 31 (91%) > 100 3(9%)) 2.35 (1.0-6.4) None Magge et al [56 ] 91 54.3 (24-77) 50:41 CRC 54 (59.3%) Ocular melanoma 29 (32%) Others 8 (8.7%) None CRC 47 (87%) 44 (48%) 30% (5%-80%) 9 (2-105) NR NR Fukumoto et al [57 ] 68 60 (52-67) 61:7 HCC 68 (100%) NR None NR NR NR ≥ 4 8.3 (5.0-12.6) None Alexander et al [58 ] 120 52 (22-74) 41:79 CRC NR NR NR 20% (5%-75%) NR 8 (1-50) NR Iersel et al [59 ] 105 ≤ 70 78:27 CRC 4 (3.8%) 51 (48.6%) 50 (47.6%) NR NR NR < 10 71 (68%) ≥ 10 34 (32%) NR 34 (32.4%) Rizell et al [60 ] 27 53 (36-77) NR Melanoma NR NR NR 6 (22%) 11 (41%) 10 (37%) NR NR NR Pingpank et al [61 ] 28 49 (17-74) 14:14 Melanoma 13 CRC 2 Others 13 NR NR NR NR NR NR NR NR 8 (29%) Alexander et al [62 ] 29 49 (26-73) 15:14 Ocular melanoma NR NR NR 20 (69%) 8 (28%) 1 (3%) 25 (4 ≥ 50) 5.6 (2-14) NR
Table 3 Isolated hepatic perfusion details and response rate
Ref .Patients evaluable for response (n) IHP/PIHP IHP chemotherapy protocol Patient response Overall response (CR + PR, %) Drug Dose Perfusion temperature Perfusion time Courses per patient (n ) Complete response (%) Partial response (%) Stable disease (%) Progressive disease (%) Olofsson et al [55 ] 34 IHP Melphalan 1 mg/kg 40 °C 60 min 1 4 (12%) 19 (56%) 6 (18%) 5 (15%) 68% Magge et al [56 ] 68 IHP Melphalan Oxaliplatin Oxaliplatin + 5FU 1.5 mg/kg 40 mg/m2 5FU 200 mg/m2 40 °C 60 min 1 44 (64.7%) 24 (35.3%) 64.7% Fukumoto et al [57 ] 67 PIHP Mitomycin C and/or Doxorubicin 20-40 mg/m2 60-120 mg/m2 NR 30-40 min 1.51 (range 1-3) 21 (31.3%) 27 (40.3%) 11 (16.4%) 8 (11.9%) 71.6% Alexander et al [58 ] 114 IHP Melphalan TNF alone or both 1.5 mg/kg 1 mg 39.5 °C-40 °C 60 min 1 2 (1.8%) 67 (58.8%) NR NR 60.5% van Iersel et al [59 ] 97 IHP Melphalan 200 mg 39.5 °C 60 min 1 3 (3.1%) 49 (50.5%) 23 (23.7%) 22 (22.7%) 53.6% Rizell et al [60 ] 27 IHP Melphalan With or without TNF 0.5, 1 and 2 mg/kg 30 μg ≥ 40 °C 40-60 min 1 2 (7.4%) 17 (63.0%) 2 (7.4%) 6 (22.2%) 69.4% Pingpank et al [61 ] 27 PIHP Melphalan 2-3.5 mg/kg NR 60 min 2.64 2 (7.4%) 6 (22.2%) NR NR 29.6% Alexander et al [62 ] 29 IHP Melphalan 1.5 mg/kg NR 60 min 1 3 (10%) 15 (52%) NR NR 62%
Table 4 Isolated hepatic perfusion morbidity and mortality
Ref .Mortality Toxicity grade 3/4 (%) Complications grade 3/4 (%) Bilirubin Transaminases Alkaline phosphatase Neutropenia Platelets Anemia Hepatic artery obstruction Hepatic failure Bleeding Hypotension Wound infection Olofsson et al [55 ] None NR NR NR NR NR NR 2.90% NR NR NR NR Magge et al [56 ] 3.30% 20.50% 50.00% 3.40% 2.30% 18.20% 50.00% NR 5.70% NR 0% 3.40% Fukumoto et al [57 ] NR NR 77.90% NR 44.10% NR NR NR NR 1.50% NR 8.80% Alexander et al [58 ] 4% 46.70% 55.80% 4.20% 0.80% 10.00% NR NR 3.30% 0.80% 5.80% 2.50% van Iersel et al [59 ] 6% 18.00% 20.00% 15.20% 2.90% NR NR 1.90% NR 8.60% NR NR Rizell et al [60 ] 22% NR NR NR NR NR NR NR NR NR NR NR Pingpank et al [61 ] None 18.9% (hepatic toxicity) 66.20% 35.10% 17.60% NR NR NR NR NR Alexander et al [62 ] None 65.5% (hepatic toxicity) NR NR NR NR NR NR NR NR Pooled P 95%CI 5.4% (2.5%-11.2%) 10.3 (2%-39%) 19.2 (8.7%-37.2%) 31.9% (9.3%-68.1%) 2.2% (0.7%-6.6%) 4.5% (2.3%-8.4%) 4.50% (1.8-11.1%) 2.7% (0.3%-20.3%) 5.7% (3.1%-10.2%)
Table 5 Long-term survival outcomes after isolated hepatic perfusion
Ref .Median follow-up (mo) Median time to local progression (mo) Median time to systemic progression (mo) Median hepatic progression-free survival (mo) Overall survival Median OS (mo from IHP) 1-yr survival (%) 2-yr survival (%) 3-yr survival (%) 4-yr survival (%) 5-yr survival (%) Olofsson et al [55 ] NR 7 (0-31) 13 (2-34) NR 24 NR NR NR NR NR Magge et al [56 ] NR NR NR For CRC group: 12 (10.53-13.47) For CR: 12 For PR: 12 (10.1-13.9) For SD: 12.5 (10.53-13.47) 23 (15-28) NR NR NR NR NR Fukumoto et al [57 ] 20 (3-191) NR NR NR 25 80.6% NR 35.7% NR 27.6% Alexander et al [58 ] 78.1 (52.1-104.2) 7.3 (6.5-8.0) NR 25 (19.4-30.6) NR 53% 28% 14% NR van Iersel et al [59 ] NR NR NR 7 17.4 NR 34% NR NR NR Rizell et al [60 ] IHP I cohort: NR IHP II cohort: NR IHP III cohort: 7 (range 4-18) NR NR NR 12.6 (2.5-57) NR NR NR NR NR Alexander et al [62 ] 11 (3-40) 8 12 12.1 (3-39+) NR NR NR NR NR Median value (range) 20 (12.1-25)
Table 6 Summary of prognostic factors presented in relevant clinical trials
Ref .Year Prognostic factors for response Prognostic factors for TTLP Prognostic factors for PFS Prognostic factors for OS Olofsson et al [55 ] 2014 NR Y NR Y Magge et al [56 ] 2014 Y NR NR Y Fukumoto et al [57 ] 2014 NR NR NR Y Alexander et al [58 ] 2009 Y NR Y Y van Iersel et al [59 ] 2008 Y NR Y Y Rizell et al [60 ] 2008 NR NR NR NR Pingpank et al [61 ] 2005 NR NR NR NR Alexander et al [62 ] 2003 Y NR NR Y