Risk factors, clinical outcomes, and natural history of uveal melanoma: a single-institution analysis

We describe the characteristics of UM patients at a tertiary referral center in the Mid-Southern United States, and explore associations and predictors of outcomes. This is a retrospective cohort study of patients with UM seen at West Cancer Center, from 07/2006 to 08/2017. Clinical characteristics and their relationship to outcomes (time-to-death and metastasis) were explored using Cox regression analysis. We identified 208 patients, 51% males, 97% Caucasians, 80% were symptomatic, with a median follow-up of 2.34 years, IQR (1.01 –3.03), of which 19.2% died during follow-up. Metastases were diagnosed in 19% (4 older patients had metastases at diagnosis), 53% of those by surveillance. Without considering metastases as a time-varying covariate, age (HR = 1.06/year, CI 1.0–1.1;p <  0.001), headaches (HR = 5.7, CI 1.6–20.5;p = 0.03), and tumor stage (T) were significant covariates for time-to-death. Tumor stages T3 versus T1 (HR = 6.4; CI 1.5–27.7;p = 0.01) and T4 versus T1 (HR = 5.98; CI 1.3–27.8;p = 0.02) were associated with worse outcomes. When considering metastases as a time-varying covariate (HR = 35.8, CI 17–75.2;p <  0.001), only age remains in the model (HR = 1.04/year;p <  0.001). However, tumor stage (p <  0.001), headaches (p = 0.008), and age (p <  0.001) are associated with time-to-metastasis. One in five patients developed metastasis which was the most influential factor on mor...
Source: Medical Oncology - Category: Cancer & Oncology Source Type: research