Validation of a Prognostic Staging for Metastatic Uveal Melanoma: A Collaborative Study of the European Ophthalmic Oncology Group

Abstract

This multicenter study confirms that the Working Formulation is a reliable and valid, repeatable system for dividing metastatic uveal melanoma into distinct prognostic subgroups, especially for stage-specific reporting of survival in prospective clinical trials.

Meta-analysis in metastatic uveal melanoma to determine progression free and overall survival benchmarks: an international rare cancers initiative (IRCI) ocular melanoma study

“…Several prognostic factors for overall survival in metastatic uveal melanoma patients have been proposed from previous studies [54][55][56]. Here we sought to validate and build upon these in patients participating in clinical trials.…”

“…They may be earlier in the disease trajectory, but we could not evaluate line of therapy as a factor due to these data being variably defined in each trial, or their improved survival may reflect a more indolent disease due to biological factors or surveillance imaging. Moreover, a recent analysis suggested that performance status, LDH and diameter of the largest liver metastasis at baseline may not efficiently predict prognosis if liver surgery is part of the treatment [56]. Increasing disease burden in the liver appeared to be associated with increased disease elsewhere but we were unable to determine whether the site of first metastases was substantial as previously reported [57] nor if time from diagnosis of primary tumour or metastatic disease to start of treatment correlated with increased disease burden (the data were not obtainable or largely missing in our dataset).…”

Selective internal radiation therapy (SIRT) as treatment for hepatic metastases of uveal melanoma: a Finnish nation-wide retrospective experience

“…Prognosis in metastatic uveal melanoma is poor. The median overall survival (OS) of 249 patients from seven European ocular oncology centers was 13.5 months, and 53% of the patients survived >1 year, 22% survived >2 years and 10% survived >3 years [17]. In this multicenter study, the patient population was heterogenous and were treated with a wide spectrum of different treatment modalities beginning from best supportive care to liver resection.…”

“…Prognostic models for risk factors associated with survival have been developed [14,15]. Similarly, staging for patients with newly identified metastases have been proposed and validated [16][17][18]. These models share performance index, a measure of metastatic extent such as the largest dimension of the largest metastasis, and serum levels of transaminases, lactate dehydrogenase (LDH) and alkaline phosphatase (ALP).…”

Metastatic uveal melanoma managed with best supportive care

“…There is no published survival data on consecutive patients managed with best supportive care (BSC) to allow historical comparison with those actively treated, although such data would be valuable for planning and analysing trials of metastatic UM, most of which continue to be non-randomised and non-comparative [8,9]. We report population-based OS according to previously validated prognostic stages [10] for patients with metastatic UM managed only with BSC.…”