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.