title: The Liverpool uveal melanoma liver metastases pathway: outcome following liver resection.
abstract: OBJECTIVE
  To determine the outcome of patients that underwent liver resection for metastases from uveal melanoma.
  
  
  METHODS
  Over a 9-year period, patients referred with uveal melanoma metastases were included. Following treatment of primary uveal melanoma, high-risk patients were offered to be enrolled into a 6-monthly non-contrast liver magnetic resonance imaging (MRI) surveillance. Following detection of liver metastases, patients were staged with a contrast-enhanced (Primovist(®)) liver MRI, computer tomography (CT) of the thorax and staging laparoscopy.
  
  
  RESULTS
  155 patients were referred with uveal melanoma liver metastases, of which 17 (11.0%) patients had liver resection and one patient was treated with percutaneous radio-frequency ablation. The majority of patients undergoing liver resection were treated with multiple metastectomies (n = 8) and three patients had major liver resections. The overall median survival for patients treated with surgery/ablation was 27 (14-90) months, and this was significantly better compared to patients treated palliatively [median = 8(1-30) months, P < 0.001]. Following surgery, 11 patients had recurrent disease [median = 13(6-36) months]. Patients who had undergone a major liver resection had a significantly poorer disease-free survival (P = 0.037).
  
  
  CONCLUSIONS
  Patients who can undergo surgical resection for metastatic uveal melanoma have a more favorable survival compared to those who do not.
authors.affiliation: North Western Hepatobiliary Unit, Aintree University Hospital NHS Foundation Trust, Liverpool, UK.
authors.forename: D
authors.initials: D
authors.lastname: Gomez
authors.forename: C
authors.initials: C
authors.lastname: Wetherill
authors.forename: J
authors.initials: J
authors.lastname: Cheong
authors.forename: L
authors.initials: L
authors.lastname: Jones
authors.forename: E
authors.initials: E
authors.lastname: Marshall
authors.forename: B
authors.initials: B
authors.lastname: Damato
authors.forename: S E
authors.initials: SE
authors.lastname: Coupland
authors.forename: P
authors.initials: P
authors.lastname: Ghaneh
authors.forename: G J
authors.initials: GJ
authors.lastname: Poston
authors.forename: H Z
authors.initials: HZ
authors.lastname: Malik
authors.forename: S W
authors.initials: SW
authors.lastname: Fenwick
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006498:Hepatectomy; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging / Q000379:methods; D010166:Palliative Care; D011159:Population Surveillance; D013902:Radiography, Thoracic; D014057:Tomography, X-Ray Computed; D014604:Uveal Neoplasms / Q000473:pathology*
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: hepatectomy; hepatic resection; melanoma; metastases; ocular