The Liverpool uveal melanoma liver metastases pathway: outcome following liver resection

J Surg Oncol. 2014 May;109(6):542-7. doi: 10.1002/jso.23535. Epub 2013 Dec 19.

Abstract

Aim: To determine the outcome of patients that underwent liver resection for metastases from uveal melanoma.

Methods: Over a 9-year period, patients referred with uveal melanoma metastases were included. Following treatment of primary uveal melanoma, high-risk patients were offered to be enrolled into a 6-monthly non-contrast liver magnetic resonance imaging (MRI) surveillance. Following detection of liver metastases, patients were staged with a contrast-enhanced (Primovist(®)) liver MRI, computer tomography (CT) of the thorax and staging laparoscopy.

Results: 155 patients were referred with uveal melanoma liver metastases, of which 17 (11.0%) patients had liver resection and one patient was treated with percutaneous radio-frequency ablation. The majority of patients undergoing liver resection were treated with multiple metastectomies (n = 8) and three patients had major liver resections. The overall median survival for patients treated with surgery/ablation was 27 (14-90) months, and this was significantly better compared to patients treated palliatively [median = 8(1-30) months, P < 0.001]. Following surgery, 11 patients had recurrent disease [median = 13(6-36) months]. Patients who had undergone a major liver resection had a significantly poorer disease-free survival (P = 0.037).

Conclusions: Patients who can undergo surgical resection for metastatic uveal melanoma have a more favorable survival compared to those who do not.

Keywords: hepatectomy; hepatic resection; melanoma; metastases; ocular.

MeSH terms

  • Adult
  • Aged
  • Catheter Ablation
  • Contrast Media
  • Female
  • Gadolinium DTPA
  • Hepatectomy*
  • Humans
  • Laparoscopy
  • Liver Neoplasms / mortality*
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Melanoma / mortality*
  • Melanoma / pathology
  • Melanoma / secondary
  • Melanoma / surgery*
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasm Staging / methods
  • Palliative Care
  • Population Surveillance
  • Radiography, Thoracic
  • Tomography, X-Ray Computed
  • Uveal Neoplasms / pathology*

Substances

  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA