Trends in the Multidisciplinary Treatment of Liver Tumors
Trends in the Multidisciplinary Treatment of Liver Tumors
Keihlolz from the Charitè Comprehensive Cancer Center (Berlin, Germany) reported in his talk the important differences between the four melanomas (cutaneous solar, cutaneous nonsolar, mucosal and uveal). This differentiation is currently of capital importance as it has become the cornerstone for target-oriented differentiation of oncological treatments. In fact, among those four types of melanoma, many differences in genomic mutations (braf, met and c-kit) reflect different biological behaviors and, therefore, different sensitivities to molecular therapies.
We can also interpret the talk of Adam from the Paul Brousse Hospital (Vilejuif, France) reporting on how this differentiation has a clinical consequence especially for the treatment of metastatic liver disease along similar lines. In fact the largest series published shows how some selection criteria for treatment of metastatic liver melanomas should be used in order to improve clinical outcomes. Liver metastases from uveal melanomas seem to have a significantly better prognosis, which, to date, seems to be the only type of melanoma in which liver resection improves prognosis, mainly in patients with one to three metastases and a metachronous presentation of at least 2 years disease-free survival. In selected cases rehepatectomy could also be taken into consideration. Liver metastatic cutaneous melanomas recur usually very early on and frequently. Present diagnostic options does not allow to detect miliaric dissemination of melanomas (typical metastatic pattern of this tumor); to date this remains an unsolved problem.
Melanoma
Keihlolz from the Charitè Comprehensive Cancer Center (Berlin, Germany) reported in his talk the important differences between the four melanomas (cutaneous solar, cutaneous nonsolar, mucosal and uveal). This differentiation is currently of capital importance as it has become the cornerstone for target-oriented differentiation of oncological treatments. In fact, among those four types of melanoma, many differences in genomic mutations (braf, met and c-kit) reflect different biological behaviors and, therefore, different sensitivities to molecular therapies.
We can also interpret the talk of Adam from the Paul Brousse Hospital (Vilejuif, France) reporting on how this differentiation has a clinical consequence especially for the treatment of metastatic liver disease along similar lines. In fact the largest series published shows how some selection criteria for treatment of metastatic liver melanomas should be used in order to improve clinical outcomes. Liver metastases from uveal melanomas seem to have a significantly better prognosis, which, to date, seems to be the only type of melanoma in which liver resection improves prognosis, mainly in patients with one to three metastases and a metachronous presentation of at least 2 years disease-free survival. In selected cases rehepatectomy could also be taken into consideration. Liver metastatic cutaneous melanomas recur usually very early on and frequently. Present diagnostic options does not allow to detect miliaric dissemination of melanomas (typical metastatic pattern of this tumor); to date this remains an unsolved problem.
