The Use of Transarterial Chemoembolization in the Treatment of Patients with Uveal Melanoma with Isolated Metastatic Liver Disease.

Purpose: To evaluate the tolerability and efficacy of transarterial chemoembolization (TACE) in the treatment of patients with metastatic liver disease from uveal melanoma. Materials and methods: From 2000 to 2024, 131 patients with uveal melanoma underwent liver TACE for metastatic liver disease at the N.N. Blokhin National Medical Research Center of Oncology of the Russian Ministry of Health. The treatment was carried out for multiple bilobar liver disease (110 patients) and solitary/single liver metastases (21 patients). A total of 283 TACEs were performed. The duration of observation after TACE ranged from 1 to 152 months. The median observation was 11 months. Results: TACE was technically successful in 100 % of cases. Postembolization syndrome of varying severity was observed in 82.4 %. Mortality 0 %. Local response (according to mRECIST) was observed in 75/131 (57.2 %) patients. Overall survival (OS) (n=131) was: 1-year — 78.5 %, 2-year — 47 %, %, 3-year — 17 %. Median overall survival was 23 months. In the group of patients who received only TACE (n=29): 1-year OS — 66 %, 2-year OS — 27 %, 3-year OS — 13 %. In the TACE + additional treatment group (n=102) — 1-year OS — 82.2 %, 2-year OS — 50.3 %, 3-year OS — 23.7 %. Conclusions: TACE is a safe treatment option for patients with uveal melanoma with different volumes of liver metastases. Local response in slightly more than half of patients indicates the need for a more rigorous definition of indications for this intervention. Ourresults with TACE indicate the need for further research to determine the optimal timing of the combination of regional interventional treatment with systemic drug therapy, surgery, and liver chemoperfusion.

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