Intensive Surveillance and Aggressive Multimodal Treatment for Liver Metastases From Uveal Melanoma
No Thumbnail Available
Authors
Kocher,Hemant M.
Gani,Akil
Belibagli,Ziya O.
Shankar,Adithi
Saad,Amina
Mawire,Karen
Wassef,Amr
Chin Aleong,Jo-Anne
Sheaff,Michael
Stamp,Gordon
Check for full-text access
Issue Date
2025
Type
Article
Language
Keywords
Alternative Title
Abstract
OBJECTIVE: We evaluated a cohort of patients with liver metastasis from uveal melanoma (LMUM) to assess the benefit of intensive surveillance and multimodal treatment on overall survival. BACKGROUND: LMUM is typically associated with a poor prognosis. PATIENTS AND METHODS: This two-center retrospective cohort study from January 2010 to December 2024 included 58 patients with LMUM deemed to be oligometastatic and referred for surgical management. Overall survival after treatment of LMUM and primary uveal melanoma was determined using Kaplan-Meier methods and the Cox proportional hazards method. RESULTS: Fifty-eight patients performance status (PS): PS1 = 11, PS0 = 47] with oligometastatic LMUM were screened to stratify patients with multifocal disease not undergoing liver surgical/ablative treatment (Group A, n = 27) and those with oligometastatic liver disease having liver resection/ablation (Group B, n = 31) along with systemic treatment as per patient/physician choice. Patients in Group B had longer liver-specific overall survival Group B: OS = 45.1 (95% confidence interval (CI) = 33.5-not reached] months; Group A, median 18.6 (95% CI = 13.8-23.8) months; P < 0.0001, log-rank (Mantel-Cox) test, hazard ratio (HR): 0.13, 95% CI = 0.06-0.28) and better overall survival from initial treatment for primary uveal melanoma Group B 14.1 (95% CI = 8.2-20.8) years vs Group A 3.6 (95% CI = 2.5-5.5) years; P < 0.0001, HR: 0.24, (95% CI = 0.11-0.50)]. CONCLUSIONS: Intensive surveillance for early diagnosis of oligometastatic LMUM and its relapse along with surgical resection/ablation and systemic treatment facilitates long-term remission. This retrospective case series requires prospective validation in a multicenter cohort study.
Description
Citation
Publisher
License
Journal
Annals of surgery open : perspectives of surgical history, education, and clinical approaches
Volume
6
Issue
4