Annals of surgical oncology · 2025
Intention-to-Treat Analysis of Hepatic Resection for Liver Metastases from Uveal Melanoma: A Single-Center Experience.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Maspero Marianna, Pezzoli Isabella, Di Guardo Lorenza, Angi Martina, Lo Dico Silvia, Sposito Carlo, Battiston Carlo, Mazzaferro Vincenzo
Аннотация
BACKGROUND: Uveal melanoma metastasizes to the liver in almost 50% of patients. The prognosis of liver metastases from uveal melanoma (LMUM) is dismal; however, results from retrospective monocentric series suggest that surgery may improve survival in selected patients. We report our results of surgical explorations and hepatic resections for LMUM.
METHODS: We retrospectively analyzed our prospectively collected institutional database of hepatic resections for LMUM between 2013 and 2023.
RESULTS: In total, 22 patients underwent surgical exploration (median age 61 years, 41% female patients): 15 (68%) underwent curative-intent surgery (surgery group) while 7 (32%) had their resection aborted owing to intraoperatively unresectable disease (staging alone group). Patients in the surgery group had a longer interval between diagnosis of the primary tumor and LMUM (> 36 months in 64%, versus 29% in the staging alone group, p = 0.18). Preoperative imaging and intraoperative staging were concordant in ten (45%) cases, while five (23%) had more lesions, six (27%) had miliary disease, and one (4.5%) had peritoneal carcinomatosis. Minor postoperative complications occurred in 3 (14%) patients. All patients in the staging alone group underwent subsequent systemic or locoregional treatment. Median overall survival was 27 (15-47) months after surgery and 15 (8-21) months after staging alone. Recurrence after surgery occurred in 7/15 patients, with a median disease-free survival of 28 (4-38) months.
CONCLUSIONS: More than 30% of patients with LMUM with preoperatively resectable disease are unresectable at explorative surgery. Acceptable recurrence rates and good survival outcomes are observed when radical surgery can be performed.
METHODS: We retrospectively analyzed our prospectively collected institutional database of hepatic resections for LMUM between 2013 and 2023.
RESULTS: In total, 22 patients underwent surgical exploration (median age 61 years, 41% female patients): 15 (68%) underwent curative-intent surgery (surgery group) while 7 (32%) had their resection aborted owing to intraoperatively unresectable disease (staging alone group). Patients in the surgery group had a longer interval between diagnosis of the primary tumor and LMUM (> 36 months in 64%, versus 29% in the staging alone group, p = 0.18). Preoperative imaging and intraoperative staging were concordant in ten (45%) cases, while five (23%) had more lesions, six (27%) had miliary disease, and one (4.5%) had peritoneal carcinomatosis. Minor postoperative complications occurred in 3 (14%) patients. All patients in the staging alone group underwent subsequent systemic or locoregional treatment. Median overall survival was 27 (15-47) months after surgery and 15 (8-21) months after staging alone. Recurrence after surgery occurred in 7/15 patients, with a median disease-free survival of 28 (4-38) months.
CONCLUSIONS: More than 30% of patients with LMUM with preoperatively resectable disease are unresectable at explorative surgery. Acceptable recurrence rates and good survival outcomes are observed when radical surgery can be performed.