title: Characterization of computed tomography scan abnormalities in patients with biopsy-proven hepatic metastases from uveal melanoma.
abstract: OBJECTIVE
  To describe the computed tomography (CT) features in patients with biopsy-proven hepatic metastases of uveal melanoma and correlate these findings with survival.
  
  
  METHODS
  The medical records of patients with uveal melanoma evaluated at Memorial Sloan-Kettering Cancer Center from January 1998 to September 2009 were reviewed. Inclusion criteria were biopsy-proven liver metastasis and CT scan images available within 2 months of biopsy. Exclusion criteria were prior systemic or liver-directed therapy for uveal melanoma. Statistical analyses were carried out using the t test, χ(2) test, and Kaplan-Meier log-rank analyses.
  
  
  RESULTS
  Of 505 medical records reviewed, 76 were selected for study. Characteristic CT findings included multiple (68 patients [90%]), hypodense (100%), heterogeneous (100%), and enhancing (100%) hepatic lesions with a mean dominant lesion size of 46.8 cm(2). Eighteen patients (24%) exhibited hepatomegaly. Predominant lesion size larger than 100 cm(2), hepatomegaly, and ascites correlated with a lower survival rate (P = .008, P < .001, and P < .001, respectively). Radiographic evidence of extrahepatic metastases was present in 40 patients (53%). However, the presence of extrahepatic metastases did not affect survival. The results of at least 1 liver function test were abnormal in 46 of 67 patients (69%), and elevation of at least 1 serum transaminase and elevation of alkaline phosphatase were associated with larger lesions (P = .009 and P = .004, respectively) and hepatomegaly (P < .001 for both).
  
  
  CONCLUSIONS
  Radiographic evidence of predominant lesion size larger than 100 cm(2), hepatomegaly, and ascites-but not radiographic evidence of extrahepatic metastases-correlate with a lower survival rate in patients with biopsy-proven hepatic metastases of uveal melanoma.
authors.affiliation: Department of Surgery, Memorial Sloan-Kettering Cancer Center, 70 E 66th St, New York, NY 10065, USA.
authors.forename: Mrinali
authors.initials: M
authors.lastname: Patel
authors.forename: Corinne B
authors.initials: CB
authors.lastname: Winston
authors.forename: Brian P
authors.initials: BP
authors.lastname: Marr
authors.forename: Richard D
authors.initials: RD
authors.lastname: Carvajal
authors.forename: Gary K
authors.initials: GK
authors.lastname: Schwartz
authors.forename: Jedd
authors.initials: J
authors.lastname: Wolchok
authors.forename: Klaus
authors.initials: K
authors.lastname: Busam
authors.forename: David H
authors.initials: DH
authors.lastname: Abramson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D005260:Female; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000556:secondary; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000401:mortality / Q000556:secondary; D008875:Middle Aged; D015996:Survival Rate; D014057:Tomography, X-Ray Computed; D014604:Uveal Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology; D055815:Young Adult