First Author: D.Lorenzo SPAIN
Co Author(s): J. Caminal L. Arias P. Garcia Bru E. Cobos B. Dias N. Padron-Perez
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To determine the clinical factors that influence survival in patients with metastatic uveal melanoma.
Tertiary referral service in ocular oncology.
Single-centre, retrospective review of patient medical records. The following data of ninety-nine consecutive patients (49 men and 50 women) with metastatic uveal melanoma were registered: patient demographics; primary tumour characteristics; features of first melanoma-related metastasis; symptoms and patient status at distant disease debut; and metastasis treatments. Overall survival was analyzed by Kaplan-Meier estimates. A Cox proportional hazards regression model was applied to identify independent predictors associated with survival.
Mean patient age at metastatic diagnosis was 60.7 years (standard deviation, 12.8). The liver was the first metastatic site in most (92.9%) cases. The median disease-free interval was 26 months (interquartile range, 34). Median overall survival after detection of the first metastasis was 8 months (interquartile range, 14). The baseline characteristics of the primary uveal melanoma were not associated with survival in patients with stage IV disease. On the multivariate analysis, the following factors at first metastatic diagnosis were associated with improved overall survival: age ≤ 65 years; disease-free interval > 36 months; better performance status; and normal serum lactate dehydrogenase and gamma glutamyl transpeptidase levels. Overall survival was not influenced by the specific metastatic treatment.
Although metastatic uveal melanoma has a poor prognosis, this study reveals the existence of several independent prognostic factors for prolonged overall survival. These findings may help to improve survival estimates in patients with advanced disease.