Local Recurrence Significantly Increases the Risk of Metastatic Uveal Melanoma

Brenda L. Gallie, E. Rand Simpson, Svetlana Saakyan, Anush Amiryan, Vladimir Valskiy, Paul T. Finger, Kimberly J. Chin, Ekaterina Semenova, Stefan Seregard, Maria Fili, Matthew Wilson, Barrett Haik, Jose M. Caminal, Jaume Catala, Cristina Gutierrez, David E. Pelayes, Anibal Martin Folgar, Martine J. Jager, Mehmet Dogrusoz, Gregorius P.M. Luyten & 4 others Arun Singh, Andrew P. Schachat, Shigenobu Suzuki, Yukiko Aihara

Research output: Contribution to journalArticle

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Abstract

To assess of the effect of local recurrence of uveal melanoma on metastasis using a multicenter international tumor registry. Design Retrospective study using an online tumor registry. Participants Patients with uveal melanoma diagnosed between 2001 and 2011. Methods A committee was formed to create uveal melanoma patient-specific data fields. Ten subspecialty ophthalmic oncology centers from 4 continents shared data. Patient selection criteria included diagnosis of uveal melanoma and adequate records to allow tumor staging by American Joint Committee on Cancer (AJCC) criteria and follow-up for metastatic melanoma. Main Outcome Measures Local tumor recurrence and metastatic uveal melanoma. Results Of 3809 total entries, 3217 patients with ciliary body and choroidal (CBC) melanoma and 160 with iris melanoma were evaluated. There was a median follow-up of 3.7 years (95% confidence interval [CI], 3.5-3.8). One hundred fifty-two patients (4.7%) with CBC melanoma experienced local recurrence, with a cumulative incidence of 11%. Kaplan-Meier point estimates for remaining free of local recurrence were 99% (95% CI, 99-99) at 1 year, 93% (95% CI, 92-94) at 5 years, and 89% (95% CI, 86-91) at 10 years. Five-and 10-year metastasis-free Kaplan-Meier estimates for the recurrence-free group were 87% (95% CI, 86-89) and 82% (95% CI, 79-84), and those for the local recurrence group were 71% (95% CI, 62-78) and 62% (95% CI, 49-72). The difference between these 2 groups was statistically significant (P < 0.001). Furthermore, local tumor recurrence increased the risk of metastasis by a hazard ratio (HR) of 6.28 (95% CI, 4.4-8.9; P < 0.001). Local recurrence was detected up to 9.8 years after treatment. Extrascleral extension also was associated with local recurrence (HR, 3.2; 95% CI, 1.5-6.7; P = 0.003), but higher AJCC T-size category was not (P = 0.63). Five patients (n = 5/161 [3.1%]) with iris melanoma demonstrated local recurrence and 1 metastasized. Conclusions International multicenter data sharing was used to evaluate the effect of local tumor recurrence on metastatic rate. In that local tumor recurrence was associated with a significantly higher risk of systemic metastasis, effective initial treatment and long-term surveillance of treated uveal melanoma patients is necessary.

Original languageEnglish (US)
Pages (from-to)86-91
Number of pages6
JournalOphthalmology
Volume123
Issue number1
DOIs
StatePublished - Jan 1 2016

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Recurrence
Confidence Intervals
Melanoma
Neoplasms
Neoplasm Metastasis
Ciliary Body
Kaplan-Meier Estimate
Iris
Patient Selection
Registries
Uveal melanoma
Information Dissemination
Neoplasm Staging
Retrospective Studies
Outcome Assessment (Health Care)
Incidence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Gallie, B. L., Simpson, E. R., Saakyan, S., Amiryan, A., Valskiy, V., Finger, P. T., ... Aihara, Y. (2016). Local Recurrence Significantly Increases the Risk of Metastatic Uveal Melanoma. Ophthalmology, 123(1), 86-91. https://doi.org/10.1016/j.ophtha.2015.09.014

Local Recurrence Significantly Increases the Risk of Metastatic Uveal Melanoma. / Gallie, Brenda L.; Simpson, E. Rand; Saakyan, Svetlana; Amiryan, Anush; Valskiy, Vladimir; Finger, Paul T.; Chin, Kimberly J.; Semenova, Ekaterina; Seregard, Stefan; Fili, Maria; Wilson, Matthew; Haik, Barrett; Caminal, Jose M.; Catala, Jaume; Gutierrez, Cristina; Pelayes, David E.; Folgar, Anibal Martin; Jager, Martine J.; Dogrusoz, Mehmet; Luyten, Gregorius P.M.; Singh, Arun; Schachat, Andrew P.; Suzuki, Shigenobu; Aihara, Yukiko.

In: Ophthalmology, Vol. 123, No. 1, 01.01.2016, p. 86-91.

Research output: Contribution to journalArticle

Gallie, BL, Simpson, ER, Saakyan, S, Amiryan, A, Valskiy, V, Finger, PT, Chin, KJ, Semenova, E, Seregard, S, Fili, M, Wilson, M, Haik, B, Caminal, JM, Catala, J, Gutierrez, C, Pelayes, DE, Folgar, AM, Jager, MJ, Dogrusoz, M, Luyten, GPM, Singh, A, Schachat, AP, Suzuki, S & Aihara, Y 2016, 'Local Recurrence Significantly Increases the Risk of Metastatic Uveal Melanoma', Ophthalmology, vol. 123, no. 1, pp. 86-91. https://doi.org/10.1016/j.ophtha.2015.09.014
Gallie BL, Simpson ER, Saakyan S, Amiryan A, Valskiy V, Finger PT et al. Local Recurrence Significantly Increases the Risk of Metastatic Uveal Melanoma. Ophthalmology. 2016 Jan 1;123(1):86-91. https://doi.org/10.1016/j.ophtha.2015.09.014
Gallie, Brenda L. ; Simpson, E. Rand ; Saakyan, Svetlana ; Amiryan, Anush ; Valskiy, Vladimir ; Finger, Paul T. ; Chin, Kimberly J. ; Semenova, Ekaterina ; Seregard, Stefan ; Fili, Maria ; Wilson, Matthew ; Haik, Barrett ; Caminal, Jose M. ; Catala, Jaume ; Gutierrez, Cristina ; Pelayes, David E. ; Folgar, Anibal Martin ; Jager, Martine J. ; Dogrusoz, Mehmet ; Luyten, Gregorius P.M. ; Singh, Arun ; Schachat, Andrew P. ; Suzuki, Shigenobu ; Aihara, Yukiko. / Local Recurrence Significantly Increases the Risk of Metastatic Uveal Melanoma. In: Ophthalmology. 2016 ; Vol. 123, No. 1. pp. 86-91.
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title = "Local Recurrence Significantly Increases the Risk of Metastatic Uveal Melanoma",
abstract = "To assess of the effect of local recurrence of uveal melanoma on metastasis using a multicenter international tumor registry. Design Retrospective study using an online tumor registry. Participants Patients with uveal melanoma diagnosed between 2001 and 2011. Methods A committee was formed to create uveal melanoma patient-specific data fields. Ten subspecialty ophthalmic oncology centers from 4 continents shared data. Patient selection criteria included diagnosis of uveal melanoma and adequate records to allow tumor staging by American Joint Committee on Cancer (AJCC) criteria and follow-up for metastatic melanoma. Main Outcome Measures Local tumor recurrence and metastatic uveal melanoma. Results Of 3809 total entries, 3217 patients with ciliary body and choroidal (CBC) melanoma and 160 with iris melanoma were evaluated. There was a median follow-up of 3.7 years (95{\%} confidence interval [CI], 3.5-3.8). One hundred fifty-two patients (4.7{\%}) with CBC melanoma experienced local recurrence, with a cumulative incidence of 11{\%}. Kaplan-Meier point estimates for remaining free of local recurrence were 99{\%} (95{\%} CI, 99-99) at 1 year, 93{\%} (95{\%} CI, 92-94) at 5 years, and 89{\%} (95{\%} CI, 86-91) at 10 years. Five-and 10-year metastasis-free Kaplan-Meier estimates for the recurrence-free group were 87{\%} (95{\%} CI, 86-89) and 82{\%} (95{\%} CI, 79-84), and those for the local recurrence group were 71{\%} (95{\%} CI, 62-78) and 62{\%} (95{\%} CI, 49-72). The difference between these 2 groups was statistically significant (P < 0.001). Furthermore, local tumor recurrence increased the risk of metastasis by a hazard ratio (HR) of 6.28 (95{\%} CI, 4.4-8.9; P < 0.001). Local recurrence was detected up to 9.8 years after treatment. Extrascleral extension also was associated with local recurrence (HR, 3.2; 95{\%} CI, 1.5-6.7; P = 0.003), but higher AJCC T-size category was not (P = 0.63). Five patients (n = 5/161 [3.1{\%}]) with iris melanoma demonstrated local recurrence and 1 metastasized. Conclusions International multicenter data sharing was used to evaluate the effect of local tumor recurrence on metastatic rate. In that local tumor recurrence was associated with a significantly higher risk of systemic metastasis, effective initial treatment and long-term surveillance of treated uveal melanoma patients is necessary.",
author = "Gallie, {Brenda L.} and Simpson, {E. Rand} and Svetlana Saakyan and Anush Amiryan and Vladimir Valskiy and Finger, {Paul T.} and Chin, {Kimberly J.} and Ekaterina Semenova and Stefan Seregard and Maria Fili and Matthew Wilson and Barrett Haik and Caminal, {Jose M.} and Jaume Catala and Cristina Gutierrez and Pelayes, {David E.} and Folgar, {Anibal Martin} and Jager, {Martine J.} and Mehmet Dogrusoz and Luyten, {Gregorius P.M.} and Arun Singh and Schachat, {Andrew P.} and Shigenobu Suzuki and Yukiko Aihara",
year = "2016",
month = "1",
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doi = "10.1016/j.ophtha.2015.09.014",
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TY - JOUR

T1 - Local Recurrence Significantly Increases the Risk of Metastatic Uveal Melanoma

AU - Gallie, Brenda L.

AU - Simpson, E. Rand

AU - Saakyan, Svetlana

AU - Amiryan, Anush

AU - Valskiy, Vladimir

AU - Finger, Paul T.

AU - Chin, Kimberly J.

AU - Semenova, Ekaterina

AU - Seregard, Stefan

AU - Fili, Maria

AU - Wilson, Matthew

AU - Haik, Barrett

AU - Caminal, Jose M.

AU - Catala, Jaume

AU - Gutierrez, Cristina

AU - Pelayes, David E.

AU - Folgar, Anibal Martin

AU - Jager, Martine J.

AU - Dogrusoz, Mehmet

AU - Luyten, Gregorius P.M.

AU - Singh, Arun

AU - Schachat, Andrew P.

AU - Suzuki, Shigenobu

AU - Aihara, Yukiko

PY - 2016/1/1

Y1 - 2016/1/1

N2 - To assess of the effect of local recurrence of uveal melanoma on metastasis using a multicenter international tumor registry. Design Retrospective study using an online tumor registry. Participants Patients with uveal melanoma diagnosed between 2001 and 2011. Methods A committee was formed to create uveal melanoma patient-specific data fields. Ten subspecialty ophthalmic oncology centers from 4 continents shared data. Patient selection criteria included diagnosis of uveal melanoma and adequate records to allow tumor staging by American Joint Committee on Cancer (AJCC) criteria and follow-up for metastatic melanoma. Main Outcome Measures Local tumor recurrence and metastatic uveal melanoma. Results Of 3809 total entries, 3217 patients with ciliary body and choroidal (CBC) melanoma and 160 with iris melanoma were evaluated. There was a median follow-up of 3.7 years (95% confidence interval [CI], 3.5-3.8). One hundred fifty-two patients (4.7%) with CBC melanoma experienced local recurrence, with a cumulative incidence of 11%. Kaplan-Meier point estimates for remaining free of local recurrence were 99% (95% CI, 99-99) at 1 year, 93% (95% CI, 92-94) at 5 years, and 89% (95% CI, 86-91) at 10 years. Five-and 10-year metastasis-free Kaplan-Meier estimates for the recurrence-free group were 87% (95% CI, 86-89) and 82% (95% CI, 79-84), and those for the local recurrence group were 71% (95% CI, 62-78) and 62% (95% CI, 49-72). The difference between these 2 groups was statistically significant (P < 0.001). Furthermore, local tumor recurrence increased the risk of metastasis by a hazard ratio (HR) of 6.28 (95% CI, 4.4-8.9; P < 0.001). Local recurrence was detected up to 9.8 years after treatment. Extrascleral extension also was associated with local recurrence (HR, 3.2; 95% CI, 1.5-6.7; P = 0.003), but higher AJCC T-size category was not (P = 0.63). Five patients (n = 5/161 [3.1%]) with iris melanoma demonstrated local recurrence and 1 metastasized. Conclusions International multicenter data sharing was used to evaluate the effect of local tumor recurrence on metastatic rate. In that local tumor recurrence was associated with a significantly higher risk of systemic metastasis, effective initial treatment and long-term surveillance of treated uveal melanoma patients is necessary.

AB - To assess of the effect of local recurrence of uveal melanoma on metastasis using a multicenter international tumor registry. Design Retrospective study using an online tumor registry. Participants Patients with uveal melanoma diagnosed between 2001 and 2011. Methods A committee was formed to create uveal melanoma patient-specific data fields. Ten subspecialty ophthalmic oncology centers from 4 continents shared data. Patient selection criteria included diagnosis of uveal melanoma and adequate records to allow tumor staging by American Joint Committee on Cancer (AJCC) criteria and follow-up for metastatic melanoma. Main Outcome Measures Local tumor recurrence and metastatic uveal melanoma. Results Of 3809 total entries, 3217 patients with ciliary body and choroidal (CBC) melanoma and 160 with iris melanoma were evaluated. There was a median follow-up of 3.7 years (95% confidence interval [CI], 3.5-3.8). One hundred fifty-two patients (4.7%) with CBC melanoma experienced local recurrence, with a cumulative incidence of 11%. Kaplan-Meier point estimates for remaining free of local recurrence were 99% (95% CI, 99-99) at 1 year, 93% (95% CI, 92-94) at 5 years, and 89% (95% CI, 86-91) at 10 years. Five-and 10-year metastasis-free Kaplan-Meier estimates for the recurrence-free group were 87% (95% CI, 86-89) and 82% (95% CI, 79-84), and those for the local recurrence group were 71% (95% CI, 62-78) and 62% (95% CI, 49-72). The difference between these 2 groups was statistically significant (P < 0.001). Furthermore, local tumor recurrence increased the risk of metastasis by a hazard ratio (HR) of 6.28 (95% CI, 4.4-8.9; P < 0.001). Local recurrence was detected up to 9.8 years after treatment. Extrascleral extension also was associated with local recurrence (HR, 3.2; 95% CI, 1.5-6.7; P = 0.003), but higher AJCC T-size category was not (P = 0.63). Five patients (n = 5/161 [3.1%]) with iris melanoma demonstrated local recurrence and 1 metastasized. Conclusions International multicenter data sharing was used to evaluate the effect of local tumor recurrence on metastatic rate. In that local tumor recurrence was associated with a significantly higher risk of systemic metastasis, effective initial treatment and long-term surveillance of treated uveal melanoma patients is necessary.

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