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Cancer Res Treat ; 50(4): 1130-1139, 2018 Oct.
Article in English | MEDLINE | ID: mdl-29198096

ABSTRACT

PURPOSE: The purpose of this study was to demonstrate the existence of a bimodal survival pattern in metastatic uveal melanoma. Secondary aims were to identify the characteristics and prognostic factors associated with long-term survival and to develop a clinical decision tree. MATERIALS AND METHODS: The medical records of 99 metastatic uveal melanoma patients were retrospectively reviewed. Patients were classified as either short (≤ 12 months) or long-term survivors (> 12 months) based on a graphical interpretation of the survival curve after diagnosis of the first metastatic lesion. Ophthalmic and oncological characteristicswere assessed in both groups. RESULTS: Of the 99 patients, 62 (62.6%) were classified as short-term survivors, and 37 (37.4%) as long-term survivors. The multivariate analysis identified the following predictors of long-term survival: age ≤ 65 years (p=0.012) and unaltered serum lactate dehydrogenase levels (p=0.018); additionally, the size (smaller vs. larger) of the largest liver metastasis showed a trend towards significance (p=0.063). Based on the variables significantly associated with long-term survival, we developed a decision tree to facilitate clinical decision-making. CONCLUSION: The findings of this study demonstrate the existence of a bimodal survival pattern in patients with metastatic uveal melanoma. The presence of certain clinical characteristics at diagnosis of distant disease is associated with long-term survival. A decision tree was developed to facilitate clinical decision-making and to counsel patients about the expected course of disease.


Subject(s)
Decision Trees , L-Lactate Dehydrogenase/blood , Melanoma/diagnosis , Uveal Neoplasms/diagnosis , Adult , Aged , Aged, 80 and over , Clinical Decision-Making , Female , Humans , Male , Melanoma/blood , Melanoma/metabolism , Middle Aged , Neoplasm Metastasis , Prognosis , Retrospective Studies , Risk Factors , Survival Analysis , Survival Rate , Uveal Neoplasms/blood , Uveal Neoplasms/metabolism , Young Adult
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