Efficacy and safety of the CT-guided co-ablation system in the treatment of malignant melanoma with hepatic metastasis.

Purpose: To evaluate the efficacy and safety of computed tomography (CT)-guided co-ablation in patients with hepatic metastases from malignant melanoma.

Methods: Clinical data of 79 patients with hepatic metastases from malignant melanoma who underwent co-ablation (integration of cryoablation and thermal ablation) and programmed death 1 (PD-1) treatment between October 2019 and January 2024 were retrospectively analyzed. The patients were divided into group A (n = 50), patients who received co-ablation, and group B (n = 29), patients who received PD-1 treatment. In group A, treatment efficacy and safety, changes in lymphocyte subsets, Th1/Th2 cell cytokines before and 3 weeks after treatment, and adverse events (AEs) during co-ablation were evaluated.

Results: Co-ablation exhibited favorable clinical efficacy in the treatment of hepatic metastases from malignant melanoma. The rates of complete remission (CR), partial remission (PR), progressive disease (PD), stable disease (SD), and disease control rate (DCR) were 56.0%, 24.0%, 8.0%, 12.0%, and 92.0%, respectively. In group B, the CR, PR, PD, SD, and DCR rates were 10.3%, 24.1%, 31.0%, 34.5%, and 68.9%, respectively. Three weeks after treatment, the levels of Th2-related cytokine interleukin-10, CD3-CD16 + CD56+, and CD8 + CD25 + significantly decreased compared with baseline, with group A demonstrating lower levels than group B. At the end of the follow-up, 16 patients (32%) in group A and 16 (55.2%) in group B had died. The median progression-free survival was 20.2 months in group A, which was significantly longer than the 7.93 months in group B (P = 0.005). The median overall survival in group A was 20.2 months, which was significantly longer than the 13.5 months in group B (P = 0.025). The intraoperative AEs during co-ablation included mild pain (4.0%), hepatic arterial bleeding (2.0%), minor subcapsular bleeding (4.0%), minor pneumothorax (4.0%), and vomiting (2.0%).

Conclusion: The CT-guided co-ablation system exhibited favorable clinical efficacy and was associated with a low incidence of AEs in the treatment of hepatic metastases from malignant melanoma, indicating its potential clinical value.