Does volume change of the spleen correlate with the therapy response in uveal melanoma patients with liver metastases undergoing hepatic artery infusion chemotherapy?

Abstract

Background. Uveal melanoma (UM) patients with liver metastases often undergo hepatic artery infusion therapy (HAIC). Due to diffuse metastatic spread in the liver, patients often develop hepatomegaly and secondary, portal hypertension which may lead to splenomegaly. This study aims to compare spleen volumetry and the change of spleen volume (SV) for the evaluation of HAIC treatment response.

Patients and methods. In this study, 179 UM patients (mean age 64.8 ± 11.0y, 53% female) with liver metastases undergoing HAIC were included. Treatment response was analyzed by RECIST 1.1 and SV on CT imaging before and after first HAIC. The correlation of change in spleen and liver volume was analyzed with Spearman test. Overall survival (OS) was calculated as the time from the first HAIC to patient death using Kaplan-Meier test and multivariate analysis was performed for RECIST 1.1 and SV.

Results. In the study population, OS was 13.8 months (95% CI 10.6-14.7 months). Change in SV before and after first HAIC was +4% (IQR -4.0%-12.0%, p=0.49) and showed a weak correlation with OS (r=-0.11, p=0.18). UM patients with PD according to RECIST 1.1 showed an increase in SV compared to patients with SD (p=0.04). Compared to RECIST 1.1, SV is no significant prognostic factor that can identify a change in OS.

Conclusions. In uveal melanoma patients with liver metastases undergoing HAIC, neither the change of SV nor splenomegaly could be identified as prognostic factors for OS.