Hepatic metastasis from uveal melanoma: angiographic pattern predictive of survival after hepatic arterial chemoembolization.
OBJECTIVE
To identify clinical features associated with survival after hepatic arterial chemoembolization (HACE) for uveal melanoma metastasis.


METHODS
Retrospective case series including 11 men and 10 women with uveal melanoma metastasis.


RESULTS
The hepatic angiographic pattern of metastasis was infiltrative in 12 patients (57%) and nodular in 9 patients (43%). The infiltrative pattern was associated with ciliary body involvement by the primary tumor (Fisher exact test, P = .01) and extrascleral tumor extension (Fisher exact test, P = .01). Mean survival after the first HACE treatment was 7.6 months overall, 3.7 months for the patients with the infiltrative pattern, and 12.7 months for those with the nodular pattern. This difference was highly significant (Kaplan-Meier, P < .001). Chromosome 8p was found to be deleted in 4 patients with the infiltrative pattern and in no patients with the nodular pattern.


CONCLUSIONS
The hepatic metastasis pattern can be used to predict response to and survival after HACE. Loss of chromosome 8p may be a biomarker for the infiltrative metastasis pattern. Hepatic arterial chemoembolization may play an important role in the treatment of hepatic metastasis from uveal melanoma in patients with the nodular metastatic pattern. Regular screening for hepatic metastasis in patients with uveal melanoma may be beneficial in identifying those who would benefit from HACE.
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St Louis, MO 63110, USA.
Pouya N
PN
Dayani
Jennifer E
JE
Gould
Daniel B
DB
Brown
Karun V
KV
Sharma
Gerald P
GP
Linette
J William
JW
Harbour
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016461:Chemoembolization, Therapeutic; D002945:Cisplatin / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality* / Q000556:secondary*; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality* / Q000556:secondary*; D008875:Middle Aged; D016685:Mitomycin / Q000008:administration & dosage; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014604:Uveal Neoplasms / Q000473:pathology*
D016685:Mitomycin; D004317:Doxorubicin; D002945:Cisplatin