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Updated: May 28, 2025
Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma
Published on: January 25, 2015
Characterizing uveal melanoma patients with peritoneal metastases: A retrospective single-center analysis
Stanislav Rosnev1, Caroline A Peuker2, Iris Piwonski3
1Department of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Background:
Metastatic uveal melanoma (mUM) is an aggressive cancer predominately affecting the liver. Peritoneal metastases (PM) occur rarely, and there is limited knowledge about this subgroup´s clinical course and biology.
Methods:
We analyzed 41 mUM patients with confirmed PM from the Charité-Universitätsmedizin Berlin database, focusing on clinical characteristics, immune cell infiltrates, genetic alterations and tumor mutational burden (TMB).
Results:
The incidence of PM in mUM was 4.27 %. Metastatic disease was diagnosed 3.6 years after primary UM, with PM developing later (median: 4.7 years). Median overall survival (OS) from mUM diagnosis was 22.4 months. Prognosis correlated with metastatic pattern. Patients presenting with synchronous liver and peritoneal metastases or primary hepatic metastases followed by secondary peritoneal dissemination showed a median OS of 19.7 and 17.7 months, respectively. However, PM patients with exclusive extrahepatic disease at diagnosis of mUM had a significantly longer OS of 48.6 months and this metastatic pattern showed highly significant correlation with low and intermediate genetic risk. Metastasis-free survival and OS upon mUM diagnosis were significantly shorter in patients with high-risk UM tumors. TMB also correlated with metastatic pattern, being lowest in patients presenting with only extrahepatic disease. Higher TMB was generally associated with shorter OS.
Conclusion:
PM in mUM patients is rare and in contrast to other extra-abdominal tumors does not worsen prognosis. Prognosis is greatly influenced by the metastatic pattern, which is determined by tumor biology, as evidenced by its correlation with genetic risk groups and TMB.
Insights
Peritoneal metastases (PM) are rare in metastatic uveal melanoma (mUM). Prognosis depends on the metastatic pattern, not solely on PM presence, and is linked to tumor biology and genetic risk.
Area of Science:
- Oncology
- Cancer Biology
- Genetics
Background:
- Metastatic uveal melanoma (mUM) is an aggressive cancer primarily affecting the liver.
- Peritoneal metastases (PM) are an uncommon manifestation of mUM with limited clinical and biological understanding.
Purpose of the Study:
- To investigate the clinical course, biology, and prognostic factors of mUM patients with peritoneal metastases.
- To analyze the correlation between metastatic patterns, genetic alterations, and tumor mutational burden (TMB) in mUM with PM.
Main Methods:
- Retrospective analysis of 41 mUM patients with confirmed PM from a single institution.
- Evaluation of clinical characteristics, immune cell infiltrates, genetic alterations, and TMB.
- Correlation of metastatic patterns with overall survival (OS) and genetic risk groups.
Main Results:
- The incidence of PM in mUM was 4.27%. PM developed later than other metastatic sites (median 4.7 years post-primary UM diagnosis).
- Prognosis varied significantly with metastatic pattern; exclusive extrahepatic disease at mUM diagnosis correlated with longer OS (48.6 months) and lower genetic risk.
- High-risk UM tumors and higher TMB were associated with shorter metastasis-free survival and OS, with lowest TMB observed in patients with only extrahepatic disease.
Conclusions:
- Peritoneal metastases in mUM do not inherently worsen prognosis compared to other extra-abdominal tumors.
- The metastatic pattern, influenced by tumor biology (genetic risk, TMB), is the primary determinant of prognosis in mUM patients with PM.
