Chemoembolization for liver metastases from uveal melanoma

Background: The clinical course of patients with recurrent uveal (ocular) melanoma is nearly always dominated by the presence of liver metastases. Systemic chemotherapy has minimal activity against these tumors. Therefore, a regional hepatic approach-chemoembolization-is a reasonable palliative maneuver for patients with uveal melanoma metastatic to the liver. Methods: Twelve patients with liver-dominant metastatic uveal melanoma were chemoembolized with gelfoam powder and chemotherapy. Patients who responded to the treatment and remained eligible at the time of hepatic progression were offered a second chemoembolization. Results: There were four partial responses (33%), but only one response lasted more than six months. The median survival of all patients was five months. There were two treatment-associated deaths. Conclusions: Chemoembolization, as done in this report, offers minimal benefit to most patients with liver-dominant, metastatic uveal melanoma. More effective chemotherapy is needed for this approach to offer significant palliation.