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P46. Percutaneous versus isolated hepatic perfusion for metastatic uveal melanoma: a propensity score-matched analysis

Thursday, March 5, 2026
3:00 PM - 3:07 PM MST
Location: 301D
Introduction: A diagnosis of metastatic uveal melanoma (UM) confers a markedly poor prognosis, driven by the disease’s high propensity for hepatic metastasis. Percutaneous hepatic perfusion (PHP) and isolated hepatic perfusion (IHP) are two methods to isolate the liver and regionally deliver melphalan to metastatic UM with limited systemic exposure. Both PHP and IHP have demonstrated significant improvement in progression free survival (PFS) and hepatic response rates compared with best alternative care (BAC) in several clinical studies but with different safety profiles. Given that direct comparisons are currently limited to systematic reviews and meta-analyses, our goal was to perform a propensity score-matched analyses to compare outcomes between PHP and IHP.


Methods: A retrospective review of a prospectively collected database included UM patients with liver metastasis treated with at least one PHP or IHP from 2008-2024 at two centers. The two groups were propensity score matched (PSM) for presence of extra-hepatic metastases, largest liver tumor diameter, number of hepatic metastases, age and sex.


Results: 154 patients were identified (110 underwent IHP and 44 underwent at least one PHP). Mean age for IHP was 60.9 years and 59.8 for PHP. 62 patients were matched under a 1:1 ratio between the two groups and were well-balanced. On Kaplan- Meier analysis (KM) (figure 1), there were no significant differences between IHP and PHP in terms of overall PFS (median 11.3 vs 10.7 months), hepatic PFS (median 12.8 vs 14.5 months) and extrahepatic PFS (median 14.2 vs 11.9 months). Disease specific survival (DSS) (median 16.1 vs 24.2 months) and overall survival (OS) (median 16.1 vs 22.4 months) were also not significantly different. However, we see a clinically relevant 6-8 month improvement in DSS and OS favoring PHP.


Conclusions: In this first propensity score matched analysis comparing IHP and PHP, there was a 6-8 month clinically relevant improvement in DSS and OS favoring PHP, although not significantly significant. This supports the use of PHP as it is less invasive, applicable to more centers in terms of program setup requirements, less complex and repeatable compared to IHP without sacrificing survival.

Learning Objectives:

  • Describe the roles of Percutaneous Hepatic Perfusion (PHP) and Isolated Hepatic Perfusion (IHP) as regional therapies for liver metastases in uveal melanoma
  • Analyze the comparative survival outcome between patients treated with PHP versus IHP based on this propensity score-matched analysis.
  • Describe the clinical implications and advantages of PHP in the treatment of metastatic uveal melanoma