Comparative Effectiveness of Transarterial Chemoembolization versus Transarterial Radioembolization for Hepatic Metastases from Uveal Melanoma: A Multi-Institutional Analysis

Wednesday, April 15, 2026

12:27 PM - 12:36 PM ET

Location: 717

Presenting Author(s)

Alexander Maddock, MD

Radiology Resident
University of Miami Health System, United States

Author/Co-author(s)

Rohit Reddy, MD

IR Resident
Department of Interventional Radiology, University of Miami, United States
AB

Ansh Bhatia, MD

IR Resident
Department of Interventional Radiology, University of Miami, India
Waseem Wahood, MD, MS

Resident
Jackson Memorial Hospital, University of Miami, United States
Anders Gould, MD

IR Resident
University of Miami, Miller School of Medicine, United States
RT

Renil S. Titus, MD

Research Fellow
Department of Urology, Houston Methodist Hospital., United States
MS

Muhammad Usman Shahid, MD

Assistant Professor of Interventional Radiology
University of Miami Miller School of Medicine, United States

Purpose: In patients with uveal melanoma and hepatic metastases, outcomes remain poor, and the optimal liver-directed therapy is not well defined. This study compared survival outcomes between transarterial chemoembolization (TACE) and transarterial radioembolization (TARE) using a large federated health research network.

Materials and Methods: We conducted a retrospective cohort study using the TriNetX US Collaborative Network, encompassing 71 healthcare organizations. Patients with uveal melanoma (ICD-10: C69.2–C69.4) and secondary liver metastases (ICD-10: C78.7) treated with either TACE or TARE were identified. The TACE cohort (n=135) included patients undergoing chemoembolization, while the TARE cohort (n=250) received yttrium-90 radioembolization. Propensity score matching generated 120 well-balanced pairs. The primary outcome was overall survival, analyzed using Kaplan–Meier curves survival analysis and Cox proportional hazards regression. Secondary analyses assessed risk ratios and event frequency.

Results: After matching, baseline demographics were balanced between groups (mean age: TACE 62.6±12.0 vs TARE 63.4±11.2 years; p=0.571). Mortality was 60.0% (72/120) in the TACE group versus 57.5% (69/120) in the TARE group (risk difference 2.5%, 95% CI: -10.0% to 15.0%, p=0.694). Median survival was shorter for TACE compared to TARE (320 days vs 524 days). Kaplan-Meier analysis showed a trend toward improved survival with TARE, though this did not reach statistical significance (log-rank test p=0.064). The hazard ratio for death was 1.367 (95% CI: 0.981-1.905, p< 0.001) favoring TARE over TACE.

Conclusion: In this multi-institutional analysis of uveal melanoma patients with hepatic metastases, TARE demonstrated a trend toward longer median survival compared with TACE, though statistical significance was not achieved. The hazard ratio suggests a potential survival benefit with TARE. These real-world data support future larger prospective studies to clarify the role of TARE in optimizing liver-directed therapy for this high-risk population.