Clinical prognostic factors for distant metastases and survival in patients with primary uveal melanoma: A 10-year follow-up of a single center cohort study

Abstract

8546 Background: Metastases from uveal melanoma have an extremely poor prognosis. Factors predicting development of metastases and survival are of critical importance for future adjuvant trials investigating innovative immunotherapeutic approaches in patients with uveal melanoma. Methods: We reanalyzed all patients with uveal melanoma, who received primary treatment in 1994 and 1995 in our hospital, from whom we previously had reported 5-year follow-up data. Data on primary tumor, local therapy and follow-up were collected. Results: Of 271 patients 78.2% of patients were available for 10 years follow up. Median follow-up was 123 months. A total of 68 patients (25.1%) developed metastases. Kaplan-Meier analysis revealed a 10-year progression free survival (PFS) of 65% for the whole patient cohort. 10-year PFS was 25% in patients with extraocular tumor growth (EOG). Patients with ciliary body involvement (CBI) or a largest tumor diameter (LTD) > 14 mm had a 10-year PFS of 56.3% and 52%, respectively, which was significantly lower than in patients without ciliary body involvement or LTD < 14 mm. 10-year overall survival was 57.5% for the whole patient cohort. 10-year survival was 20% in patients with EOG and 42.3% in patients with CBI and 43.2% in patients with LTD > 14 mm. Univariate analysis revealed EOG, CBI and LTD > 14 mm to be predictive for overall survival (p < 0.02, log-rank test for all variables). Conclusions: This study confirmed our previous 5-year follow-up data and determined determined ciliary body involvement and a largest tumor diameter > 14 mm to be the most important clinical risk factor for metastases and survival. Therefore patients with ciliary body involvement and LTD > 14 mm are candidates for adjuvant therapeutic interventions within future trials. No significant financial relationships to disclose.