Laparoscopic management of liver metastases from uveal melanoma

• Published in: Surgical endoscopy Vol. 30; no. 6; pp. 2567 - 2571
• Main Authors: Akyuz, Muhammet, Yazici, Pınar, Dural, Cem, Yigitbas, Hakan, Okoh, Alexis, Bucak, Emre, McNamara, Michael, Singh, Arun, Berber, Eren
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-06-2016; Springer Nature B.V
• Subjects: Abdominal Surgery; Ablation; Biopsy; Catheter Ablation; Chemotherapy; Chi-square test; Embolization; Female; Gastroenterology; Gynecology; Hepatectomy; Hepatology; Humans; Laparoscopy; Liver diseases; Liver Neoplasms - mortality; Liver Neoplasms - secondary; Liver Neoplasms - surgery; Male; Medicine; Medicine & Public Health; Melanoma; Melanoma - mortality; Melanoma - pathology; Melanoma - secondary; Melanoma - surgery; Metastasis; Middle Aged; Patients; Proctology; Retrospective Studies; Surgery; Ultrasonic imaging; Uveal Neoplasms - pathology; United States > US; Laparoscopic liver resection; Uveal melanoma; Liver metastases; Laparoscopic radiofrequency ablation
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-015-4527-9

Background
Although uveal melanoma is a rare disease, its metastasis to the liver is associated with a poor survival. The aim of this study is to analyze the survival after surgical treatment of uveal melanoma metastases to the liver.
Methods
Within 15 years, 44 patients with uveal melanoma metastases to the liver were managed at a single center. Medical records were reviewed to identify patients who underwent surgical treatment of their liver disease. Clinical and oncologic results were compared to those patients who were managed otherwise.
T
test, Chi-square test, and Kaplan–Meier survival analyses were performed.
Results
There were 16 patients who underwent surgical treatment (laparoscopic liver resection,
n
 = 2 and laparoscopic radiofrequency ablation,
n
 = 14), compared to 28 patients who received systemic therapy. The groups were similar regarding demographics and size of primary tumor. The interval between diagnoses of primary tumor and liver metastases was longer for the surgical group (58 vs 22 months, respectively,
p
 = 0.010). Although the dominant liver tumor size was similar, the average number of liver tumors was 4 in the surgical group and 10 in the systemic therapy group (
p
 < 0.0001). The median survival after diagnosis of liver metastases was 35 months in the surgical group and 15 months in the systemic therapy group (
p
 ≤ 0.0001). Five-year survival was zero in the systemic therapy group and 22 % in the surgical group.
Conclusions
This study shows that surgical treatment of liver metastases in selected patients with uveal melanoma, who have limited liver tumor burden and a long interval to metastases development, may result in long-term survival.