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Medical Oncology

, 36:17 | Cite as

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

  • Glenda M. Delgado-Ramos
  • Fridtjof Thomas
  • Ari VanderWalde
  • Benjamin King
  • Matthew Wilson
  • Arnel M. PalleraEmail author
Original Paper

Abstract

Uveal melanoma (UM) is the most common primary intraocular malignancy in adults. 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 mortality. Predictors of mortality were metastasis, age, tumor stage, and headache as a reported symptom. Surveillance successfully diagnosed metastatic disease in most patients. Most patients had symptoms preceding their UM diagnosis highlighting an opportunity for earlier recognition of UM.

Keywords

Uveal melanoma Ocular melanoma Non-cutaneous melanoma Mid-Southern United States 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Glenda M. Delgado-Ramos
    • 1
  • Fridtjof Thomas
    • 2
  • Ari VanderWalde
    • 1
    • 3
  • Benjamin King
    • 4
  • Matthew Wilson
    • 4
  • Arnel M. Pallera
    • 1
    • 3
    Email author
  1. 1.Department of Internal MedicineUniversity of Tennessee Health Science CenterMemphisUSA
  2. 2.Division of Biostatistics, Department of Preventive MedicineUniversity of Tennessee Health Science CenterMemphisUSA
  3. 3.Division of Hematology and OncologyWest Cancer CenterGermantown, MemphisUSA
  4. 4.Department of OphthalmologyUniversity of Tennessee Health Science Center - Hamilton Eye InstituteMemphisUSA

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