{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:16:42Z","timestamp":1778692602748,"version":"3.51.4"},"reference-count":67,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2013,12,2]],"date-time":"2013-12-02T00:00:00Z","timestamp":1385942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2014,3,15]]},"abstract":"<jats:p>Effective management of hepatic metastases from ocular and cutaneous melanoma remains a major therapeutic challenge. Treatment options include hepatic resection, hepatic intra\u2010arterial (HIA) chemotherapy, chemoembolization, and hepatic perfusions. Evaluating the efficacy of these interventions is limited by the retrospective nature of most of the data, although controlled phase 3 studies are starting to emerge. Studies of hepatic resection are strongly suggestive of a survival benefit following surgery in selected patients. Effective systemic agents for metastatic cutaneous melanoma are available and supported by randomized controlled phase 3 trials. In contrast, no active systemic treatment has yet been identified for metastatic ocular melanoma. HIA and intravenous delivery of fotemustine have been compared in a randomized phase 3 trial in patients with unresectable metastases from melanoma, but no differences between the 2 approaches were observed. Hepatic arterial chemoembolization appears only to be moderately effective according to uncontrolled studies; targeting patients with less liver involvement may improve outcomes. A recent phase 3 study showed a significant improvement in hepatic progression\u2010free survival with percutaneous hepatic perfusion compared with best alternative care in patients with metastatic melanoma; however, the overall survival analysis was confounded by crossover of control patients to active treatment. In conclusion, hepatic resection offers the possibility of long\u2010term survival in carefully selected patients with liver\u2010limited metastases from melanoma. In patients with unresectable cutaneous melanoma, effective systemic therapy is the best treatment option. For patients with unresectable ocular melanoma, regional treatments are likely to assume a greater role until effective systemic treatments are identified. <jats:bold><jats:italic>Cancer<\/jats:italic> 2014;120:781\u2013789<\/jats:bold>. \u00a9 <jats:italic>2013 American Cancer Society<\/jats:italic>.<\/jats:p>","DOI":"10.1002\/cncr.28480","type":"journal-article","created":{"date-parts":[[2013,12,2]],"date-time":"2013-12-02T11:13:18Z","timestamp":1385982798000},"page":"781-789","source":"Crossref","is-referenced-by-count":101,"title":["Metastatic melanoma to the liver: A contemporary and comprehensive review of surgical, systemic, and regional therapeutic options"],"prefix":"10.1002","volume":"120","author":[{"given":"Sanjiv S.","family":"Agarwala","sequence":"first","affiliation":[{"name":"Department of Hematology\/Oncology St. Luke's University Health Network Bethlehem Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander M. 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