Abstract
e21631 Background: Uveal melanoma (UM) is the most common primary intraocular malignancy in adults with an incidence of 6 cases per million in the US. We sought to describe the characteristics of our UM patients and explore associations and predictors of outcomes. Methods: We retrospectively analyzed patients with UM treated at West Cancer Center, Memphis, TN, from 07/2006 to 08/2017. Clinical characteristics and outcomes (death and metastasis) were explored. The relative importance of variables with respect to outcome was studied by time-to-event analysis using Cox proportional hazards model. Results: There were 244 patients with a median follow-up of 34 months, IQR (12, 62) (Table 1). Four patients (1.6%), all < 55 years, had metastasis at presentation, while 19.3% subsequently developed metastasis. Death occurred in 46 patients (19.2%) (mortality rate of 4.6/1,000 patient-years), of which 32 (70%) were diagnosed with metastasis, with 24 (75%) dying < 1 year from metastatic diagnosis. There was no difference in treatment modality in patients who died (p = 0.75) or developed metastasis (p = 0.41), compared to those who did not. Symptoms were present in 184 patients (75%) prior to diagnosis, with change in vision the most common (83%). Age (HR = 1.1/year, 1.02-1.08), tumor size (T4, HR = 9.8, 1.2-81) and family history (FHx) of nonmelanoma skin cancer (HR = 4.4, 1.8-11) were significant covariates for mortality; likewise for metastasis. Metastasis was the strongest predictor of death (HR = 29.1, 14.5-58.6). Younger patients had higher alcohol use (p = 0.04). Conclusions: One in 5 patients developed metastasis which was the most influential factor on mortality. Predictors of mortality and metastasis were age, tumor size and FHx of skin cancer. Most patients had preceding symptoms highlighting an opportunity for earlier recognition in primary care and primary ophthalmologic specialties. The possible association with skin cancers merits further research. Table 1. Patients' characteristics, N = 244; [n, (%)] Median age, y (range) 59 (16-89) Female 123 (50) Caucasian 235 (96) Tumor size T1 = 41 (17); T2 = 57 (23); T3 = 52 (21); T4 = 25 (10) Brachytherapy 212 (87) Choroid involvement 225 (92) Alcohol use 90 (36) Tobacco use 109 (45)
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