Abstract
Uveal melanoma (UM) is fatal in ~50% of patients as a result of disseminated disease. This study aims to externally validate the Liverpool Uveal Melanoma Prognosticator Online V3 (LUMPO3) to determine its reliability in predicting survival after treatment for choroidal melanoma when utilizing external data from other ocular oncology centers. Anonymized data of 1836 UM patients from seven international ocular oncology centers were analyzed with LUMPO3 to predict the 10-year survival for each patient in each external dataset. The analysts were masked to the patient outcomes. Model predictions were sent to an independent statistician to evaluate LUMPO3’s performance using discrimination and calibration methods. LUMPO3’s ability to discriminate between UM patients who died of metastatic UM and those who were still alive was fair-to-good, with C-statistics ranging from 0.64 to 0.85 at year 1. The pooled estimate for all external centers was 0.72 (95% confidence interval: 0.68 to 0.75). Agreement between observed and predicted survival probabilities was generally good given differences in case mix and survival rates between different centers. Despite the differences between the international cohorts of patients with primary UM, LUMPO3 is a valuable tool for predicting all-cause mortality in this disease when using data from external centers.
Highlights
Uveal melanoma (UM) is a rare eye cancer occurring in adults, causing liver metastasis in approximately 50% of cases [1]
Numerous prognostic factors have been identified for primary UM
Data Collection In November 2017, a call for participation in this external validation of Liverpool Uveal Melanoma Prognosticator Online V3 (LUMPO3) was made to 14 centers involved in OOG and collaborative studies (Figure 3)
Summary
Uveal melanoma (UM) is a rare eye cancer occurring in adults, causing liver metastasis in approximately 50% of cases [1]. After detection of metastatic disease, most patients die within a year, with only a few responding to current therapies [2]. There is some evidence that prognostication in UM improves the quality of life of some patients, even when the probability of survival is poor [3,4,5]. Prognostication is an important aspect of patient care, identifying high-risk UM patients requiring special care (e.g., increased frequency of liver surveillance using high-resolution imaging, enrollment in clinical trials of systemic adjuvant therapy including immunotherapies [6]), while allowing low-risk UM patients to be reassured and to have less intensive surveillance. Many predictive factors of metastasis from UM have been identified [3]
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