Surgical interventions improve survival in patients with metastatic uveal melanoma

Background

Metastatic uveal melanoma (UM) has a poor prognosis. UM predominately metastasizes to the liver. Surgical treatment of liver metastasis from uveal melanoma (LMUM) remains controversial. We evaluated the survival of LMUM patients treated with different primary (enucleation, proton beam, Ruthenium plaque, stereotactic radiosurgery and metastatic surgical interventions (resection ± radiofrequency ablation – RFA) compared with chemotherapy alone or no treatment.

Methods

100 LMUM patients were studied. 33 had surgical interventions, 46 had chemotherapy alone and 21 had no treatment. Mean survival time was analysed for each primary and metastatic treatment group. The overall difference in survival times from primary diagnosis and metastatic diagnosis was analysed using chi-squared and log rank tests.

Results

Mean survival times (months) since metastatic diagnosis for the surgery group (40.088) and RFA + surgery group (34.010) were significantly longer than the chemotherapy group (21.631) and the no treatment group (8.325); p<0.001. Time interval differences between primary and metastatic diagnoses were not significant between secondary metastatic treatment groups but were significant between primary treatment groups (p=0.003): multiple primary treatments and ruthenium plaque had the longest intervals.

Conclusion

This retrospective study highlights how survival can be improved by surgical management of LMUM patients in selected cases.