BACKGROUND Uveal melanoma (UM) is a rare malignancy with a propensity for metastasis to the liver. Systemic chemotherapy is typically ineffective in these patients with liver metastases and overall survival is poor. There are no evidence-based guidelines for management of UM liver metastases. The aim of this study was to review the evidence for management of UM liver metastases. METHODS A systematic review of English literature publications was conducted across Ovid Medline, Ovid MEDLINE and Cochrane CENTRAL databases until April 2019. The primary outcome was overall survival, with disease free survival as a secondary outcome. RESULTS 55 studies were included in the study, with 2446 patients treated overall. The majority of these studies were retrospective, with 17 of 55 including comparative data. Treatment modalities included surgery, isolated hepatic perfusion (IHP), hepatic artery infusion (HAI), transarterial chemoembolization (TACE), selective internal radiotherapy (SIRT) and Immunoembolization (IE). Survival varied greatly between treatments and between studies using the same treatments. Both surgery and liver-directed treatments were shown to have benefit in selected patients. CONCLUSION Predominantly retrospective and uncontrolled studies suggest that surgery and locoregional techniques may prolong survival. Substantial variability in patient selection and study design makes comparison of data and formulation of recommendations challenging.

中文翻译：

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葡萄膜黑色素瘤肝转移肝脏定向治疗的系统评价。

背景葡萄膜黑色素瘤（UM）是一种罕见的恶性肿瘤，具有转移到肝脏的倾向。全身化疗对这些肝转移患者通常无效，总生存期很差。没有关于 UM 肝转移管理的循证指南。本研究的目的是回顾管理 UM 肝转移的证据。方法 对截至 2019 年 4 月的 Ovid Medline、Ovid MEDLINE 和 Cochrane CENTRAL 数据库中的英文文献出版物进行了系统评价。主要结果是总生存期，无病生存期作为次要结果。结果 本研究共纳入 55 项研究，总共治疗了 2446 名患者。大多数这些研究是回顾性的，55 项研究中有 17 项包括比较数据。治疗方式包括手术、离体肝灌注 (IHP)、肝动脉灌注 (HAI)、经动脉化疗栓塞 (TACE)、选择性内部放疗 (SIRT) 和免疫栓塞 (IE)。治疗之间和使用相同治疗的研究之间的存活率差异很大。手术和肝脏导向治疗均显示对特定患者有益。结论 主要是回顾性和非对照研究表明手术和局部区域技术可以延长生存期。患者选择和研究设计的巨大差异使得数据的比较和建议的制定具有挑战性。治疗之间和使用相同治疗的研究之间的存活率差异很大。手术和肝脏导向治疗均显示对特定患者有益。结论 主要是回顾性和非对照研究表明手术和局部区域技术可以延长生存期。患者选择和研究设计的巨大差异使得数据的比较和建议的制定具有挑战性。治疗之间和使用相同治疗的研究之间的存活率差异很大。手术和肝脏导向治疗均显示对特定患者有益。结论 主要是回顾性和非对照研究表明手术和局部区域技术可以延长生存期。患者选择和研究设计的巨大差异使得数据的比较和建议的制定具有挑战性。