Nation‐wide survival outcomes of metastatic uveal melanoma with best supportive care

Abstract

AbstractPurposeTo report overall survival (OS) of patients with metastatic uveal melanoma who received best supportive care (BSC).MethodsRetrospective cohort study of patients with primary uveal melanoma treated between January 1999 and December 2016 at a national referral center and diagnosed with metastasis before December 2016. The patients who received BSC as the only treatment were enrolled. Complete data for all patients was requested from all hospitals that had participated in management. Age, gender, time from primary tumour to metastasis, presence of symptoms, locations of metastases, largest metastasis diameter, WHO performance index, and liver function tests were collected. Predicted median survival time calculated according to the Ophthalmic Oncology Group (OOG)‐validated Helsinki University Hospital Working Formulation (HUCH‐WF) was used to assign patients to stages IVa, IVb, and IVc, which correspond to predicted survival times of >12, <12–6, and <6 months, respectively. Primary endpoint was OS estimated with Kaplan–Meier analysis.ResultsThe median OS was 1.6 months (range 0–65.8, 95% CI 1.0–3.4) from the beginning of treatment in 84 patients. According to the HUCH‐WF, 20 (23%) patients with known survival time were assigned to stage IVa, 16 (19%) to IVb, 41 (49%) to IVc, and 7 (8%) were missing data. OS according to the HUCH‐WF was 11.1 months (95% CI 8.3–22.0) in stage IVa, 3.4 months (95% CI 1.0–10.0) in IVb, and 0.7 months (95% CI 0.4–0.9) in IVc.ConclusionsHUCH‐WF can differentiate by OS patients who receive BSC. The OS for stage IVa disease was similar to the median OS of 12.8 months reported in a meta‐analysis for all patients who receive active treatment. However, divided by HUCH‐WF, comparison with our data suggest that patients who receive active treatment for stage IVa and IVb disease might live on average 7 months longer (OS 18.6, 10.7, and 4.6 months for stage IVa, IVb, and IVc, respectively, in the OOG validation study).