Prognostic Factors and Decision Tree for Long-Term Survival in Metastatic Uveal Melanoma.
- Author:
Daniel LORENZO
1
;
María OCHOA
;
Josep Maria PIULATS
;
Cristina GUTIÉRREZ
;
Luis ARIAS
;
Jaume CATALÀ
;
María GRAU
;
Judith PEÑAFIEL
;
Estefanía COBOS
;
Pere GARCIA-BRU
;
Marcos Javier RUBIO
;
Noel PADRÓN-PÉREZ
;
Bruno DIAS
;
Joan PERA
;
Josep Maria CAMINAL
Author Information
- Publication Type:Original Article
- Keywords: Uveal melanoma; Neoplasm metastasis; Long-term survivors; Decision trees
- MeSH: Clinical Decision-Making; Decision Trees*; Diagnosis; Humans; L-Lactate Dehydrogenase; Liver; Medical Records; Melanoma*; Multivariate Analysis; Neoplasm Metastasis; Retrospective Studies; Survivors
- From:Cancer Research and Treatment 2018;50(4):1130-1139
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: The purpose of this study was to demonstrate the existence of a bimodal survival pattern in metastatic uveal melanoma. Secondary aims were to identify the characteristics and prognostic factors associated with long-term survival and to develop a clinical decision tree. MATERIALS AND METHODS: The medical records of 99 metastatic uveal melanoma patients were retrospectively reviewed. Patients were classified as either short (≤ 12 months) or long-term survivors (> 12 months) based on a graphical interpretation of the survival curve after diagnosis of the first metastatic lesion. Ophthalmic and oncological characteristicswere assessed in both groups. RESULTS: Of the 99 patients, 62 (62.6%) were classified as short-term survivors, and 37 (37.4%) as long-term survivors. The multivariate analysis identified the following predictors of long-term survival: age ≤ 65 years (p=0.012) and unaltered serum lactate dehydrogenase levels (p=0.018); additionally, the size (smaller vs. larger) of the largest liver metastasis showed a trend towards significance (p=0.063). Based on the variables significantly associated with long-term survival, we developed a decision tree to facilitate clinical decision-making. CONCLUSION: The findings of this study demonstrate the existence of a bimodal survival pattern in patients with metastatic uveal melanoma. The presence of certain clinical characteristics at diagnosis of distant disease is associated with long-term survival. A decision tree was developed to facilitate clinical decision-making and to counsel patients about the expected course of disease.
