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Treatment of Liver Metastases From Uveal Melanoma

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Abstract

Background

Uveal melanoma patients with liver metastases have a poor prognosis. The effect of screening and multimodality treatment (including surgery) should be evaluated.

Methods

A total of 602 patients treated for uveal melanoma during a 14-year period had abdominal ultrasonography screening every 6 months. Sixty-three developed liver metastases as the first extraocular metastatic site. When possible, liver surgery and intra-arterial catheter implantation were performed. The influence on survival of demographics, uveal tumor characteristics, liver metastasis presentation, and treatment was studied.

Results

The median time to liver metastasis was 29 months. Twenty-eight patients (44%) were operated on: 14 (22%) had R0 liver surgery, and 14 with diffuse liver involvement had R2 liver surgery (there were no significant surgical complications). Thirty-five patients with diffuse liver involvement received systemic chemotherapy or best supportive care only. The median overall survival was 15 months (range, 3–110 months): 25 months for the 14 patients with R0 surgery, 16 months for the 14 with R2 surgery, and 11 months for the 35 with chemotherapy or supportive care. By univariate analysis, age (≤70 years), number of metastases (≤10), and quality of operation (R0) were predictive of a better prognosis.

Conclusions

In the case of liver metastases from uveal melanoma, aggressive treatment permitting tumor eradication seems to offer a chance of long-term survival to selected patients. Nevertheless, neither ultrasound screening nor quality of operation had an effect on the outcome of most patients (78%). Better screening tests and more effective multimodality treatments are required to improve survival in uveal melanoma patients with hepatic metastases.

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Acknowledgments

Supported by a grant from the Léa and Napoléon Bullukian Foundation.

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Authors and Affiliations

  1. Department of Surgery, Centre Léon Bérard, 28 Rue Laennec, 69373 Lyon, Cedex, 08, France

    Michel Rivoire MD, PhD & Stefano Baldo MD

  2. Institut de Recherches Chirurgicales, Unité de Formation et de Recherche Lyon-Nord, 8 Avenue Rockefeller, 69373, Lyon, Cedex, 08, France

    Michel Rivoire MD, PhD

  3. Department of Ophthalmology, Hôpital de la Croix Rousse, 103 Grande Rue de la Croix - Rousse, 69317 Lyon, Cedex, 04, France

    Laurent Kodjikian MD, PhD & Jean-Dominique Grange MD

  4. Department of Radiology, Centre Léon Bérard, 28 Rue Laennec, 69373 Lyon, Cedex, 08, France

    Pierre Kaemmerlen MD

  5. Department of Medicine, Centre Léon Bérard, 28 Rue Laennec, 69373 Lyon, Cedex, 08, France

    Sylvie Négrier MD, PhD

Authors
  1. Michel Rivoire MD, PhD
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  2. Laurent Kodjikian MD, PhD
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  3. Stefano Baldo MD
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  4. Pierre Kaemmerlen MD
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  5. Sylvie Négrier MD, PhD
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  6. Jean-Dominique Grange MD
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Corresponding author

Correspondence to Michel Rivoire MD, PhD.

Additional information

Presented at the 27th Congress of the Societa Italiana di Chirurgia Oncologica, May 29–31, 2003, and published as an abstract

Published by Springer Science+Business Media, Inc. © 2005 The Society of Surgical Oncology, Inc.

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Rivoire, M., Kodjikian, L., Baldo, S. et al. Treatment of Liver Metastases From Uveal Melanoma. Ann Surg Oncol 12, 422–428 (2005). https://doi.org/10.1245/ASO.2005.06.032

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  • DOI: https://doi.org/10.1245/ASO.2005.06.032

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