Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Graefe's Archive for Clinical and Experimental Ophthalmology
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology 10/2005

01-10-2005 | Clinical Investigation

Prognostic factors of liver metastases from uveal melanoma

Authors: Laurent Kodjikian, Jean-Daniel Grange, Stéphano Baldo, Stéphanie Baillif, Justus G. Garweg, Michel Rivoire

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 10/2005

Login to get access

Abstract

Objectives

This study was designed to assess survival and identify prognostic factors for liver metastases diagnosed by systematic screening in uveal melanoma patients.

Methods

Among 602 consecutive patients treated over 10 years for uveal melanoma and followed by systematic semi-annual hepatic screening (abdominal ultrasonography), 63 (10.5%) developed liver metastases; these patients form the basis of this study. Factors including patient demographics, characteristics of the uveal tumor, metastasis-free interval, severity of liver metastatic involvement, and treatments of metastases were studied retrospectively regarding their prognostic value, using univariate (Kaplan-Meier method) and multivariate (Cox model) analyses.

Results

Thirty-five patients (55.6% of the metastatic population) received systemic chemotherapy or best supportive care only; 14 patients (22.2% of the metastatic population) diagnosed with diffuse liver involvement had cytoreductive surgery and intra-arterial chemotherapy; 14 (22.2% of the metastatic population) had complete surgical removal of liver metastases followed by postoperative intra-arterial chemotherapy. No significant surgical complications were experienced. The median overall survival after diagnosis of liver metastases was 15 months. It reached 25 months for selected patients with complete resection (P=0.0002). In this cohort of 63 patients, ten or fewer preoperatively diagnosed metastases and primary uveal melanoma not involving the ciliary body were independently associated with better prognosis.

Conclusions

This study suggests that selected patients with screened liver metastases from uveal melanoma may benefit from aggressive treatment, including surgery. The two independent favorable prognostic factors are fewer than ten metastases at screening and the absence of ciliary body involvement.
Literature
1.
Aoyama T, Mastrangelo MJ, Berd D, Nathan FE, Shields CL, Shields JA, Rosato EL, Rosato FE, Sato T (2000) Protracted survival after resection of metastatic uveal melanoma. Cancer 89:1561–1568CrossRefPubMed
2.
Bedikian AY, Kantarjian H, Young SE, Bodey GP (1981) Prognosis in metastatic choroidal melanoma. South Med J 74:574–577PubMed
3.
Bedikian AY, Legha SS, Mavligit G, Carrasco CH, Khorana S, Plager C, Papadopoulos N, Benjamin RS (1995) Treatment of uveal melanoma metastatic to the liver: a review of the M. D. Anderson Cancer Center experience and prognostic factors. Cancer 76:1665–1670PubMedCrossRef
4.
Cox D (1972) Regression models and life-tables (with discussions). J R Statist Soc Series B 34:187–220
5.
Eskelin S, Pyrhonen S, Hahka-Kemppinem M, Tuomaala S, Kivela T (2003) A prognostic model and staging for metastatic uveal melanoma. Cancer 97:465–475CrossRefPubMed
6.
Gragoudas ES, Egan KM, Seddon JM, Glynn RJ, Walsh SM, Finn SM, Munzenrider JE, Spar MD (1991) Survival of patients with metastases from uveal melanoma. Ophthalmology 98:383–389; discussion 90PubMed
7.
Gragoudas ES, Seddon JM, Egan KM, Glynn RJ, Goitein M, Munzenrider J, Verhey L, Urie M, Koehler A (1988) Metastasis from uveal melanoma after proton beam irradiation. Ophthalmology 95:992–999PubMed
8.
Gragoudas ES, Seddon JM, Egan KM, Polivogianis L, Hsieh CC, Goitein M, Verhey L, Munzenrider J, Austin-Seymour M, Urie M et al (1986) Prognostic factors for metastasis following proton beam irradiation of uveal melanomas. Ophthalmology 93:675–680PubMed
9.
Kaplan E, Meier P (1958) Non-parametric estimation from incomplete observation. J Am Stat Assoc 53:457–481CrossRef
10.
Karakousis CP, Temple DF, Moore R, Ambrus JL (1983) Prognostic parameters in recurrent malignant melanoma. Cancer 52:575–579PubMedCrossRef
11.
Kath R, Hayungs J, Bornfeld N, Sauerwein W, Hoffken K, Seeber S (1993) Prognosis and treatment of disseminated uveal melanoma. Cancer 72:2219–2223PubMedCrossRef
12.
Kodjikian L, Roy P, Rouberol F, Chauvel P, Jean-Louis B, Garweg J, Little R, Sasco A, Grange J (2004) Survival after proton-beam irradiation of uveal melanomas. Am J Ophthalmol 137:1002–1010CrossRefPubMed
13.
Leyvraz S, Spataro V, Bauer J, Pampallona S, Salmon R, Dorval T, Meuli R, Gillet M, Lejeune F, Zografos L (1997) Treatment of ocular melanoma metastatic to the liver by hepatic arterial chemotherapy. J Clin Oncol 15:2589–2595PubMed
14.
Li W, Gragoudas ES, Egan KM (2000) Metastatic melanoma death rates by anatomic site after proton beam irradiation for uveal melanoma. Arch Ophthalmol 118:1066–1070PubMed
15.
McLean IW, Foster WD, Zimmerman LE (1982) Uveal melanoma: location, size, cell type, and enucleation as risk factors in metastasis. Hum Pathol 13:123–132PubMedCrossRef
16.
McLean IW, Foster WD, Zimmerman LE (1977) Prognostic factors in small malignant melanomas of choroid and ciliary body. Arch Ophtalmol 95:48–58
17.
Oken M, Creech R, Tormey D (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5:649–655PubMedCrossRef
18.
Patel JK, Didolkar MS, Pickren JW, Moore RH (1978) Metastatic pattern of malignant melanoma. A study of 216 autopsy cases. Am J Surg 135:807–810CrossRefPubMed
19.
Peto R, Peto J (1972) Asymptotically efficient rank invariant test procedures. J R Statist Soc Series A 135:185–206CrossRef
20.
Prescher G, Bornfeld N, Hirche H, Horsthemke B, Jockel KH, Becher R (1996) Prognostic implications of monosomy 3 in uveal melanoma. Lancet 347:1222–1225CrossRefPubMed
21.
22.
Raivio I (1977) Uveal melanoma in Finland. An epidemiological, clinical, histological and prognostic study. Acta Ophthalmol Suppl 133:1–64PubMed
23.
Rajpal S, Moore R, Karakousis CP (1983) Survival in metastatic ocular melanoma. Cancer 52:334–336PubMedCrossRef
24.
Rouberol F, Roy P, Kodjikian L, Gérard J, Jean-Louis B, Grange J (2004) Survival, anatomic and functional long-term results in choroidal and ciliary body melanoma after ruthenium brachytherapy (a 15 years experience with betarays). Am J Ophthalmol 137:893–900CrossRefPubMed
25.
Salmon RJ, Levy C, Plancher C, Dorval T, Desjardins L, Leyvraz S, Pouillart P, Schlienger P, Servois V, Asselain B (1998) Treatment of liver metastases from uveal melanoma by combined surgery-chemotherapy. Eur J Surg Oncol 24:127–130CrossRefPubMed
26.
Seddon JM, Albert DM, Lavin PT, Robinson N (1983) A prognostic factor study of disease-free interval and survival following enucleation for uveal melanoma. Arch Ophthalmol 101:1894–1899PubMed
27.
Seregard S (1996) Posterior uveal melanoma. The Swedish perspective. Acta Ophthalmol Scand 74:315–329PubMedCrossRef
28.
Shammas HF, Blodi FC (1977) Prognostic factors in choroidal and ciliary body melanomas. Arch Ophthalmol 95:63–69PubMed
29.
Shields J, Shields C (1992) Introduction to melanocytic tumors of the uvea. In: Shields J, Shields C (eds) Intraocular tumors; a text and atlas. Williams & Wilkins, Philadelphia
30.
Singh AD, Wang MX, Donoso LA, Shields CL, Potter PD, Shields JA, Elston RC, Fijal B (1996) Familial uveal melanoma, III. Is the occurrence of familial uveal melanoma coincidental? Arch Ophthalmol 114:1101–1104PubMed
31.
Sobin L, Wittekind C (2002) TNM classification of malignant tumours. 6th ed. Wiley-Liss, Genève
32.
The Collaborative Ocular Melanoma Study (2001) Assessment of metastatic disease status at death in 435 patients with large choroidal melanoma in the Collaborative Ocular Melanoma Study (COMS): COMS report no. 15. Arch Ophthalmol 119:670–676
33.
The Collaborative Ocular Melanoma Study Group (1997) Factors predictive of growth and treatment of small choroidal melanoma: COMS report no. 5. Arch Ophthalmol 115:1537–1544
34.
Vidal JL, Bacin F, Albuisson E, Rozan R, Desjardins L, D’Hermies F, Grange JD, Chauvel P, Caujolle JP, Sahel J et al (1995) “Melanoma 92”. Epidemiological study of uveal melanoma in France. J Fr Ophtalmol 18:520–528PubMed
Metadata
Title
Prognostic factors of liver metastases from uveal melanoma
Authors
Laurent Kodjikian
Jean-Daniel Grange
Stéphano Baldo
Stéphanie Baillif
Justus G. Garweg
Michel Rivoire
Publication date
01-10-2005
Publisher
Springer-Verlag
Published in
Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 10/2005
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI
https://doi.org/10.1007/s00417-005-1188-8

Other articles of this Issue 10/2005

Graefe's Archive for Clinical and Experimental Ophthalmology 10/2005 Go to the issue

Clinical Investigation

Biometry and refractive outcome of eyes filled with silicone oil by standardized echography and partial coherence interferometry

Case Report

Anterior megalophthalmos with pigmentary glaucoma

Case Report

Severe ocular involvement in disseminated intravascular coagulation complicating meningococcaemia

Clinical Investigation

Vitreous collagen metabolism before and after vitrectomy

Clinical Investigation

Polypoidal choroidal vasculopathy and photodynamic therapy with verteporfin

Clinical Investigation

Serum levels of macular carotenoids in relation to age-related maculopathy