Abstract
BackgroundTo examine the all-cause mortality and uveal melanoma specific mortality among newly diagnosed uveal melanoma patients after five years. Furthermore, we assess of the effect of iris colour and having children on 5-year risk of death after diagnosis of uveal melanoma. Therefore, we assess the performance of an individual prediction model of survival from uveal melanoma.MethodsA cohort of 459 patients aged 45 to 79 years with newly diagnosed uveal melanoma was recruited between 2002 and 2004 from the Division of Ophthalmology, University of Essen, Germany. Survival probabilities were estimated by Kaplan-Meier survival analysis. The clinical and histopathological characteristics were obtained from medical records. Iris colour and childbearing history were assessed at baseline by a computer-assisted telephone interview. We used crude and multivariable Cox proportional hazards regression to estimate unadjusted and adjusted hazard ratios (HR) and corresponding 95% confidence intervals (95%CIs) with respect to death from uveal melanoma and death from all causes. We used the Cox model to estimate adjusted probabilities of primary events. For computing Harrell’s C statistics, we used a Cox model including the prognostics factors gender, age at diagnosis, ciliary body involvement, largest basal tumour diameter, and iris colour.ResultsThe 5-year uveal melanoma-specific survival probability was 82.9% (95% CI: 79.1-86.3). Main prognostic factors for the death of uveal melanoma were ciliary body involvement (HR: 1.7 (95% CI:1.0-2.8)), largest basal tumour diameter >15 mm HR: 7.0 (95% CI: 3.5-13.9), light iris colour (HR: 2.3 (95% CI: 0.9-5.8), having children (HR: 0.6 (95% CI: 0.2 - 1.7)), and gender (HR: 0.7 (95% CI: 0.4-1.1)). The value of the bootstrap-corrected C statistics was 0.76 (95% CI: 0.74-0.77).ConclusionBeyond the established prognostic factors, light iris colour also appears to be a prognostic factor for death from uveal melanoma.
Highlights
To examine the all-cause mortality and uveal melanoma specific mortality among newly diagnosed uveal melanoma patients after five years
The most common site for metastatic uveal melanoma is the liver. 80% of metastatic patients die within one year and 92% within 2 years of the diagnosis of metastases [5]
Uveal melanomas affect both sexes at equal rates, but the reported disease-specific mortality is higher among men [4,6]
Summary
To examine the all-cause mortality and uveal melanoma specific mortality among newly diagnosed uveal melanoma patients after five years. 80% of metastatic patients die within one year and 92% within 2 years of the diagnosis of metastases [5] Uveal melanomas affect both sexes at equal rates, but the reported disease-specific mortality is higher among men [4,6]. In the Collaborative Ocular Melanoma Study (COMS), Hawkins et al found cumulative age adjusted rates of death from any cause at 5 years after diagnosis of 49% with a maximum basal tumour diameter of ≥18 mm and of 31% with a diameter of
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