Citation: Rola, A.C.; Kalirai, H.; Taktak, A.F.G.; Eleuteri, A.; Krishna, Y.; Hussain, R.; Heimann, H.; Coupland, S.E. A Retrospective Analysis of 10 Years of Liver Surveillance Undertaken in Uveal Melanoma Patients Treated at the Supraregional “Liverpool Ocular Oncology Centre”, UK. Cancers 2022, 14, 2187. https://doi.org/10.3390/ cancers14092187 Academic Editor: Salvatore Grisanti Received: 18 March 2022 Accepted: 22 April 2022 Published: 27 April 2022 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). cancers Article A Retrospective Analysis of 10 Years of Liver Surveillance Undertaken in Uveal Melanoma Patients Treated at the Supraregional “Liverpool Ocular Oncology Centre”, UK Alda Cunha Rola 1 , Helen Kalirai 1,2 , Azzam F. G. Taktak 1,3 , Antonio Eleuteri 1,3 , Yamini Krishna 1,2 , Rumana Hussain 1,4 , Heinrich Heimann 1,4 and Sarah E. Coupland 1,2, * 1 Liverpool Ocular Oncology Research Group, Department of Molecular and Clinical Cancer Medicine, Institute of System Molecular and Integrative Biology, University of Liverpool, 6 West Derby Street, William Henry Duncan Building, Liverpool L7 8TX, UK; a.rola@liverpool.ac.uk (A.C.R.); h.kalirai@liverpool.ac.uk (H.K.); afgt@liverpool.ac.uk (A.F.G.T.); antonio.eleuteri@liverpool.ac.uk (A.E.); yamini.krishna@liverpoolft.nhs.uk (Y.K.); rumana.hussain@liverpoolft.nhs.uk (R.H.); heinrich.heimann1@nhs.net (H.H.) 2 Liverpool Clinical Laboratories, Department of Cellular Pathology, Liverpool University Hospitals Foundation Trust, Liverpool L7 8XP, UK 3 Department of Medical Physics and Clinical Engineering, Royal Liverpool University Hospital, Liverpool L7 8XP, UK 4 Liverpool Ocular Oncology Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool L7 8XP, UK * Correspondence: s.e.coupland@liverpool.ac.uk; Tel.: +44-0151-794-9104 Simple Summary: Around 45% of patients with uveal melanoma (UM) develop liver metastases on average 3 years after diagnosis of the primary tumour. After clinical detection of metastases, median patient survival is approximately one year. Early identification of metastases through liver surveillance is important so that targeted treatment can benefit affected patients, aiming to prolong their survival. The aim of our retrospective study was to investigate and correlate the characteristics of UM patients diagnosed and treated at a UK supraregional referral center, the Liverpool Ocular Oncology Centre (LOOC), and who were included in the Centre’s liver screening programs for screening for liver metastases. “Real-world” data on the frequency of liver screening in patients after diagnosis and treatment of primary UM are lacking. Through the liver screening program, we found that metastases were detected in 37% of the 615 UM patients studied. A new output based on the prognostic indices of the Liverpool Uveal Melanoma Prognosticator Online version 3 (LUMPO3) model was fitted to the dataset of these patients and accurately estimated the time of onset of metastases. Abstract: Purpose: To determine liver screening frequency and modality in UM patients following primary treatment, and the characteristics of detected metastases. Methods: A 10-year retrospective study of 615 UM patients undergoing liver surveillance in Liverpool. Information was collected from liver scan reports of these patients. Results: Of 615 UM patients analyzed, there were 337 men (55%) and 278 women (45%). Median age at primary treatment was 61 years (range, 22–94). At study end, median follow-up was 5.1 years, with 375 patients (61%) alive and 240 deceased (39%). Of the deceased patients, 187 (78%) died due to metastatic UM; 24 (10%) deaths were due to other causes; and 29 (12%) patients died of unknown conditions. In total, 3854 liver scans were performed in the 615 UM patients, with a median of 6.2 scans per patient (range, 1–40). Liver MRI was most frequently performed (62.8%). In total, 229 (37%) UM patients developed metastases during the study period: 150 were detected via liver surveillance and 79 were observed post-mortem. Conclusions: Metastatic UM onset is related to the size and genetic profiles of the primary UM, and can be predicted using the model LUMPO3. Regular liver surveillance allowed for timely detection of metastases, and through metastasectomy can lead to prolongation of life in some patients. Cancers 2022, 14, 2187. https://doi.org/10.3390/cancers14092187 https://www.mdpi.com/journal/cancers