Tumor Growth Rate as a Predictive Marker for Recurrence and Survival After Liver Resection in Patients with Liver Metastases of Uveal Melanoma

Background Surgical management of liver metastases of uveal melanoma (LMUM) is associated with the best survival rates, especially for patients with a low tumor burden in the liver. The aim was to determine whether the tumor growth rate (TGR 0 ) before liver resection helps predict survival in patients with resectable LMUM. Methods This retrospective study included 99 patients with LMUM treated with liver resection between November 2007 and November 2020. TGR 0 was expressed as the percentage change in tumor volume over 1 month according to two pretreatment imaging scans. Multivariate Cox analyses identified independent predictors of disease-free survival (DFS) and overall survival (OS). Results DFS and OS had a statistically significant positive linear relationship (Spearman correlation r = 0.68, p < 0.001). A disease-free interval (DFI) > 24 months and a TGR 0 ≤ 50%/month were independent factors associated with better DFS and OS. The 2-component model including TGR 0 and DFI had a mean time-dependent area under the curve (AUC) of 0.81 (95% CI, 0.75–0.86) and 0.77 (95% CI, 0.67–0.87), respectively, for predicting DFS and OS. DFI with TGR 0 defined three kinetic risk groups that had distinct DFS and OS outcomes ( p < 0.001). Cytogenetic alterations at baseline were partially predictive factors of the kinetic risk score based on TGR 0 and DFI. Discussion The assessment of TGR 0 improves prognostic stratification by identifying patients at high risk of recurrence and poor survival after liver resection. TGR 0 and DFI, reflecting tumor aggressivity, have the potential to be important markers for systemic adjuvant decisions.