Prognoses and Clinical Outcomes of Primary and Recurrent Uveal Melanoma.
- Author:
Jee Hung KIM
1
;
Su Jin SHIN
;
Soo Jin HEO
;
Eun Ah CHOE
;
Chang Gon KIM
;
Minkyu JUNG
;
Ki Chang KEUM
;
Jin Sook YOON
;
Sung Chul LEE
;
Sang Joon SHIN
Author Information
- Publication Type:Original Article
- Keywords: Uveal neoplasm; Melanoma; Recurrence; Survival; Prognosis; BAP1
- MeSH: Disease-Free Survival; Humans; Liver; Male; Melanoma*; Metastasectomy; Multivariate Analysis; Prognosis*; Radiotherapy; Recurrence; Risk Factors; Uveal Neoplasms
- From:Cancer Research and Treatment 2018;50(4):1238-1251
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Uveal melanoma has a very poor prognosis despite successful local primary tumor treatment. In this study, we investigated prognostic factors that more accurately reflected the likelihood of recurrence and survival and delineated a prognostic model that could effectively identify different risk groups based on initial clinical parameters. MATERIALS AND METHODS: Prognostic factors associated with distant recurrence, recurrence-free survival (RFS), progression-free survival, and overall survival from distant recurrence to death (OS2) were analyzed in 226 patients with stage I-III uveal melanoma who underwent primary local therapy. RESULTS: Forty-nine patients (21.7%) had distant recurrences, which occurred most frequently in the liver (87.7%). In a multivariate analysis, local radiotherapy improved RFS among patients with multiple recurrence risk factors relative to excision (not reached vs. 19.0 months, p=0.004). Patients with BRCA1-associated protein-1 (BAP1)–negative primary tumors showed a longer RFS duration after primary treatments, while those with BAP1-negative metastatic tissues had a shorter OS2 compared to those with BAP1-positive tumors, both not statistically insignificance (RFS: not reached vs. 82.0 months, p=0.258; OS2: 15.7 vs. 24.4 months, p=0.216). Male sex (hazard ratio [HR], 3.79; p=0.012), a short RFS (HR, 4.89; p=0.014), and a largest metastatic tumor linear diameter ≥ 45 mm (HR, 5.48; p=0.017) were found to correlate with worse post-recurrence survival. CONCLUSION: Risk factors could be used to classify uveal melanoma cases and subsequently direct individual treatment strategies. Furthermore, metastasectomy appears to contribute to improved survival outcomes.
