Treatment of melanoma metastases confined to the liver and future perspectives.

The prognosis for patients with liver metastases derived from melanoma is very poor. Although being the gold standard for colorectal metastases, hepatic resection for melanoma lesions is rarely possible. For patients with liver metastases from cutaneous melanoma, the liver is not the only site of disseminated disease in the majority of the cases. Most experience has been obtained in patients with liver metastases from uveal melanoma because in 40% of these patients, the liver is the only site of disease. However, in these patients, resection is frequently not possible due to the number and localization of the metastases. Results from systemic chemotherapy are poor and therefore, in order to increase response rate, regional treatment modalities like hepatic artery infusion, isolated hepatic perfusion and hepatic arterial chemoembolization can be considered. In this review, we will describe the various treatment modalities as well as new developments. (c) 2009 S. Karger AG, Basel.