Name

Survie du mélanome uvéal métastatique

Despite the availability of many new therapies to treat metastatic uveal melanoma, the poor overall survival rate has not significantly improved in recent decades. A better understanding of the clinical features that determine prognosis is needed to improve survival rates.The main purpose was to determine the clinical factors that influence survival in patients with metastatic uveal melanoma.

Single-center, retrospective review of patient medical records. The following data of ninety-nine consecutive patients (49 men and 50 women) with metastatic uveal melanoma were registered: patient demographics; primary tumor characteristics; features of first melanoma-related metastasis; symptoms and patient status at distant disease debut; and metastasis treatments. Overall survival was analyzed by Kaplan-Meier estimates. A Cox proportional hazards regression model was applied to identify independent predictors associated with survival.

Mean patient age at metastatic diagnosis was 60.7 years. The liver was the first metastatic site in most (92.9%) cases. The median disease-free interval was 26 months. Median overall survival after detection of the first metastasis was 8 months. The baseline characteristics of the primary uveal melanoma were not associated with survival in patients with stage IV disease. On the multivariate analysis, the following factors at first metastatic diagnosis were associated with improved overall survival: disease-free interval > 36 months; better performance status; and normal serum lactate dehydrogenase and gamma glutamyl transpeptidase levels. Overall survival was not influenced by the specific metastatic treatment.

Prevention of metastatic disease in uveal melanoma is crucial given the very poor prognosis in disseminated disease. The main objective of this study was to determine the most important prognostic factors for survival when the metastatic diagnosis is made. We retrospectively analyzed 95 potential prognostic factors in 99 patients with metastatic uveal melanoma. The following clinical factors at metastatic diagnosis were independent predictors of prolonged survival: lower ECOG (0-1) performance status; disease-free interval ≥ 36 months; and normal lactate dehydrogenase and gamma glutamyl transpeptidase serum levels.

This study reveals the existence of several independent prognostic factors for prolonged overall survival in metastatic uveal melanoma. These findings may help to improve survival estimates in patients with advanced disease.