Prognoses and clinical outcomes of primary and recurrent uveal melanoma

Jee Hung Kim, 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

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3 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1238-1251
Number of pages14
JournalCancer Research and Treatment
Volume50
Issue number4
DOIs
Publication statusPublished - 2018 Oct 1

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

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    Kim, J. H., Shin, S. J., Heo, S. J., Choe, E. A., Kim, C. G., Jung, M., Keum, K. C., Yoon, J. S., Lee, S. C., & Shin, S. J. (2018). Prognoses and clinical outcomes of primary and recurrent uveal melanoma. Cancer Research and Treatment, 50(4), 1238-1251. https://doi.org/10.4143/crt.2017.534