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J. Pe'er, I. Nir, M. Lotem, R. Folberg, S. Frenkel; Post Hepatectomy Survival of Metastatic Uveal Melanoma Patients . Invest. Ophthalmol. Vis. Sci. 2006;47(13):1497.
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© ARVO (1962-2015); The Authors (2016-present)
The liver is the main site of metastases in uveal melanoma patients. The purpose of this study was to evaluate the post hepatectomy survival of uveal melanoma patients with liver metastasis as a function of their disease free interval, the number of lesions found during the abdominal surgery and the surgical result (disease free or residual disease).
A retrospective analysis of data of our uveal melanoma patients in the years 1995–2005. Patients were grouped by disease free interval of ≤1, 1–5 and >5 years; by the number of lesions found during surgery: 1 metastasis, 2–3 metastases, and >3 metastases; and by the surgical borders at the end of the surgery: R0 and R1/R2. Kaplan Meyer survival analysis and ANOVA were done using JMP 5.0 (SAS Institute Inc., Cary, NC, USA).
Out of 431 patients with uveal melanoma on our database, 40 are known to have metastasis. Surgical data was available for 31 patients (17 women), with a mean age of 63 (28–93). Ten of whom are alive, and 21 are dead from metastatic disease. Overall survival was 21.6 ±4.1 months (mean ±SE). Post hepatectomy survival by disease free interval was 14.5 ±4.1, 21.1 ±4.8 and 26.3 ±11.2 months for patients who developed metastasis ≤1, 1–5 and in >5 years, respectively (Log Rank Chi square 0.6630, DF 2, p 0.7179). Post hepatectomy survival by the number of lesions found during surgery was 32.7 ±9.5, 27.4 ±19.3 and 13.4 ±1.7 months for patients with 1, 2–3 and >3 metastases, respectively (Log Rank Chi square 4.8361, DF 2, p 0.0891). Patients with one metastasis have statistically longer survival than those with >3 (R square 0.1189, F 6.0553, p 0.0208). Patients with clean surgical borders survive longer than those with residual disease (33.3 ±8.6 vs. 13.1 ±1.8 months, Log Rank Chi square 5.2167, DF 1 p 0.0224).
It is possible to significantly extend the life expectancy of patients who develop isolated hepatic metastasis by complete resection of the lesion.
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