Intensive Surveillance and Aggressive Multimodal Treatment for Liver Metastases From Uveal Melanoma

Objective: We evaluated a cohort of patients with liver metastasis from uveal melanoma (LMUM) to assess the benefit of intensive surveillance and multimodal treatment on overall survival. Background: LMUM is typically associated with a poor prognosis. Patients and methods: This two-center retrospective cohort study from January 2010 to December 2024 included 58 patients with LMUM deemed to be oligometastatic and referred for surgical management. Overall survival after treatment of LMUM and primary uveal melanoma was determined using Kaplan–Meier methods and the Cox proportional hazards method. Results: Fifty-eight patients [performance status (PS): PS1 = 11, PS0 = 47] with oligometastatic LMUM were screened to stratify patients with multifocal disease not undergoing liver surgical/ablative treatment (Group A, n = 27) and those with oligometastatic liver disease having liver resection/ablation (Group B, n = 31) along with systemic treatment as per patient/physician choice. Patients in Group B had longer liver-specific overall survival [Group B: OS = 45.1 (95% confidence interval (CI) = 33.5–not reached] months; Group A, median 18.6 (95% CI = 13.8–23.8) months; P < 0.0001, log-rank (Mantel-Cox) test, hazard ratio (HR): 0.13, 95% CI = 0.06–0.28) and better overall survival from initial treatment for primary uveal melanoma [Group B 14.1 (95% CI = 8.2–20.8) years vs Group A 3.6 (95% CI = 2.5–5.5) years; P < 0.0001, HR: 0.24, (95% CI = 0.11–0.50)]. Conclusions: Intensive surveillance for early diagnosis of oligometastatic LMUM and its relapse along with surgical resection/ablation and systemic treatment facilitates long-term remission. This retrospective case series requires prospective validation in a multicenter cohort study.