Long-term survival of uveal melanoma patients after surgery for liver metastases.
OBJECTIVE
To evaluate the posthepatectomy survival of uveal melanoma patients with liver metastases.


METHODS
Data were collected from the files in the Departments of Ophthalmology, General Surgery and Oncology, for uveal melanoma patients who were seen in the Ocular Oncology Clinic at the Hadassah Medical Center from 1988 to 2007. The main outcome was posthepatectomy survival. Statistical analysis was performed using JMP statistical software.


RESULTS
Of the 558 patients, 74 (13%) developed metastases after a median of 35.0 months from the initial diagnosis. Thirty-five patients underwent hepatectomy. These patients had similar clinical characteristics as those who did not undergo hepatectomy. The median survival time from the detection of metastasis was 3.7-fold higher in the operated patients in comparison with the non-operated patients. Posthepatectomy survival of patients who were found in surgery to have 1-5 metastatic nodules was 3.1 times longer than those with six or more lesions. The hepatectomies of 13 patients resulted in complete resection of the hepatic metastases with clean histological margins (R0). These patients survived 1.9 times longer than those with residual disease (R1/R2).


CONCLUSIONS
It is possible to extend significantly the life expectancy of uveal melanoma patients who develop isolated hepatic metastases by complete resection of the lesions.
Frenkel
S
S
Department of Ophthalmology, Hadassah University Medical Center, PO Box 12000, Jerusalem 91120, Israel.
Nir
I
I
Hendler
K
K
Lotem
M
M
Eid
A
A
Jurim
O
O
Pe'er
J
J
D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D008545:Melanoma / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome; D014604:Uveal Neoplasms