Risk factors, clinical outcomes, and natural history of uveal melanoma: a single-institution analysis
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...
Gespeichert in:
| Veröffentlicht in: | Medical oncology (Northwood, London, England) London, England), 2019-02, Vol.36 (2), p.17-9, Article 17 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 9 |
|---|---|
| container_issue | 2 |
| container_start_page | 17 |
| container_title | Medical oncology (Northwood, London, England) |
| container_volume | 36 |
| creator | Delgado-Ramos, Glenda M. Thomas, Fridtjof VanderWalde, Ari King, Benjamin Wilson, Matthew Pallera, Arnel M. |
| description | 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
|
| doi_str_mv | 10.1007/s12032-018-1230-4 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_22938450</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2179409603</sourcerecordid><originalsourceid>FETCH-LOGICAL-c400t-b150141b58ed34dfefec4b27fcd68b78fbba4060e16bd01a344181c060d19a643</originalsourceid><addsrcrecordid>eNp1kU1rFzEQxhdRbK1-AC-y4KUHY2eSbHbXm5T6AgWhKHgL2exsm7qb1CQr_L-9Wba2J08zPPnNkxmeqnqN8B4B2rOEHARngB1DLoDJJ9UxNk3PUODPp6UXTcugUXBUvUjpFoBjw_vn1ZEApZTs1XFFVy79qidjc4jpXW1n5501cx3WbMNCRTJ-rL3JayzqjUuFO9Rhqtc_VISFZuPDYj7Upk7OX8_EnE_Z5TW74MusmQ_JpZfVs8nMiV7d15Pqx6eL7-df2OW3z1_PP14yKwEyG7ABlDg0HY1CjhNNZOXA28mOqhvabhoGI0EBoRpGQCOkxA5tUUbsjZLipHq7-4ayg07WZbI3NnhPNmvOe9HJBgp1ulN3MfxeKWW9uGRpLqdQWJPm2PYSegXi0fABvQ1rLFdtlOo57yRuhrhTNoaUIk36LrrFxING0FtSek9Kl6T0lpTeVn1z77wOC40PE_-iKQDfgVSe_DXFx6__7_oX-W2duA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2169228410</pqid></control><display><type>article</type><title>Risk factors, clinical outcomes, and natural history of uveal melanoma: a single-institution analysis</title><source>MEDLINE</source><source>SpringerLink Journals</source><creator>Delgado-Ramos, Glenda M. ; Thomas, Fridtjof ; VanderWalde, Ari ; King, Benjamin ; Wilson, Matthew ; Pallera, Arnel M.</creator><creatorcontrib>Delgado-Ramos, Glenda M. ; Thomas, Fridtjof ; VanderWalde, Ari ; King, Benjamin ; Wilson, Matthew ; Pallera, Arnel M.</creatorcontrib><description>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.</description><identifier>ISSN: 1357-0560</identifier><identifier>ISSN: 1559-131X</identifier><identifier>EISSN: 1559-131X</identifier><identifier>DOI: 10.1007/s12032-018-1230-4</identifier><identifier>PMID: 30666496</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Adult ; Age ; Aged ; Clinical outcomes ; DIAGNOSIS ; Female ; HAZARDS ; Hematology ; Humans ; Internal Medicine ; Male ; MEDICAL SURVEILLANCE ; Medicine ; Medicine & Public Health ; Melanoma ; Melanoma - epidemiology ; Melanoma - mortality ; Melanoma - pathology ; Melanoma - therapy ; MELANOMAS ; METASTASES ; Metastasis ; Middle Aged ; MORTALITY ; Oncology ; Original Paper ; Pathology ; PATIENTS ; RADIOLOGY AND NUCLEAR MEDICINE ; Retrospective Studies ; Risk Factors ; Surveillance ; SYMPTOMS ; Treatment Outcome ; Uveal Neoplasms - epidemiology ; Uveal Neoplasms - mortality ; Uveal Neoplasms - pathology ; Uveal Neoplasms - therapy</subject><ispartof>Medical oncology (Northwood, London, England), 2019-02, Vol.36 (2), p.17-9, Article 17</ispartof><rights>Springer Science+Business Media, LLC, part of Springer Nature 2019</rights><rights>Medical Oncology is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-b150141b58ed34dfefec4b27fcd68b78fbba4060e16bd01a344181c060d19a643</citedby><cites>FETCH-LOGICAL-c400t-b150141b58ed34dfefec4b27fcd68b78fbba4060e16bd01a344181c060d19a643</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12032-018-1230-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12032-018-1230-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30666496$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/22938450$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Delgado-Ramos, Glenda M.</creatorcontrib><creatorcontrib>Thomas, Fridtjof</creatorcontrib><creatorcontrib>VanderWalde, Ari</creatorcontrib><creatorcontrib>King, Benjamin</creatorcontrib><creatorcontrib>Wilson, Matthew</creatorcontrib><creatorcontrib>Pallera, Arnel M.</creatorcontrib><title>Risk factors, clinical outcomes, and natural history of uveal melanoma: a single-institution analysis</title><title>Medical oncology (Northwood, London, England)</title><addtitle>Med Oncol</addtitle><addtitle>Med Oncol</addtitle><description>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.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Clinical outcomes</subject><subject>DIAGNOSIS</subject><subject>Female</subject><subject>HAZARDS</subject><subject>Hematology</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>MEDICAL SURVEILLANCE</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Melanoma</subject><subject>Melanoma - epidemiology</subject><subject>Melanoma - mortality</subject><subject>Melanoma - pathology</subject><subject>Melanoma - therapy</subject><subject>MELANOMAS</subject><subject>METASTASES</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>MORTALITY</subject><subject>Oncology</subject><subject>Original Paper</subject><subject>Pathology</subject><subject>PATIENTS</subject><subject>RADIOLOGY AND NUCLEAR MEDICINE</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Surveillance</subject><subject>SYMPTOMS</subject><subject>Treatment Outcome</subject><subject>Uveal Neoplasms - epidemiology</subject><subject>Uveal Neoplasms - mortality</subject><subject>Uveal Neoplasms - pathology</subject><subject>Uveal Neoplasms - therapy</subject><issn>1357-0560</issn><issn>1559-131X</issn><issn>1559-131X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kU1rFzEQxhdRbK1-AC-y4KUHY2eSbHbXm5T6AgWhKHgL2exsm7qb1CQr_L-9Wba2J08zPPnNkxmeqnqN8B4B2rOEHARngB1DLoDJJ9UxNk3PUODPp6UXTcugUXBUvUjpFoBjw_vn1ZEApZTs1XFFVy79qidjc4jpXW1n5501cx3WbMNCRTJ-rL3JayzqjUuFO9Rhqtc_VISFZuPDYj7Upk7OX8_EnE_Z5TW74MusmQ_JpZfVs8nMiV7d15Pqx6eL7-df2OW3z1_PP14yKwEyG7ABlDg0HY1CjhNNZOXA28mOqhvabhoGI0EBoRpGQCOkxA5tUUbsjZLipHq7-4ayg07WZbI3NnhPNmvOe9HJBgp1ulN3MfxeKWW9uGRpLqdQWJPm2PYSegXi0fABvQ1rLFdtlOo57yRuhrhTNoaUIk36LrrFxING0FtSek9Kl6T0lpTeVn1z77wOC40PE_-iKQDfgVSe_DXFx6__7_oX-W2duA</recordid><startdate>20190201</startdate><enddate>20190201</enddate><creator>Delgado-Ramos, Glenda M.</creator><creator>Thomas, Fridtjof</creator><creator>VanderWalde, Ari</creator><creator>King, Benjamin</creator><creator>Wilson, Matthew</creator><creator>Pallera, Arnel M.</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>OTOTI</scope></search><sort><creationdate>20190201</creationdate><title>Risk factors, clinical outcomes, and natural history of uveal melanoma: a single-institution analysis</title><author>Delgado-Ramos, Glenda M. ; Thomas, Fridtjof ; VanderWalde, Ari ; King, Benjamin ; Wilson, Matthew ; Pallera, Arnel M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-b150141b58ed34dfefec4b27fcd68b78fbba4060e16bd01a344181c060d19a643</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Clinical outcomes</topic><topic>DIAGNOSIS</topic><topic>Female</topic><topic>HAZARDS</topic><topic>Hematology</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>MEDICAL SURVEILLANCE</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Melanoma</topic><topic>Melanoma - epidemiology</topic><topic>Melanoma - mortality</topic><topic>Melanoma - pathology</topic><topic>Melanoma - therapy</topic><topic>MELANOMAS</topic><topic>METASTASES</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>MORTALITY</topic><topic>Oncology</topic><topic>Original Paper</topic><topic>Pathology</topic><topic>PATIENTS</topic><topic>RADIOLOGY AND NUCLEAR MEDICINE</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Surveillance</topic><topic>SYMPTOMS</topic><topic>Treatment Outcome</topic><topic>Uveal Neoplasms - epidemiology</topic><topic>Uveal Neoplasms - mortality</topic><topic>Uveal Neoplasms - pathology</topic><topic>Uveal Neoplasms - therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Delgado-Ramos, Glenda M.</creatorcontrib><creatorcontrib>Thomas, Fridtjof</creatorcontrib><creatorcontrib>VanderWalde, Ari</creatorcontrib><creatorcontrib>King, Benjamin</creatorcontrib><creatorcontrib>Wilson, Matthew</creatorcontrib><creatorcontrib>Pallera, Arnel M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>OSTI.GOV</collection><jtitle>Medical oncology (Northwood, London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Delgado-Ramos, Glenda M.</au><au>Thomas, Fridtjof</au><au>VanderWalde, Ari</au><au>King, Benjamin</au><au>Wilson, Matthew</au><au>Pallera, Arnel M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors, clinical outcomes, and natural history of uveal melanoma: a single-institution analysis</atitle><jtitle>Medical oncology (Northwood, London, England)</jtitle><stitle>Med Oncol</stitle><addtitle>Med Oncol</addtitle><date>2019-02-01</date><risdate>2019</risdate><volume>36</volume><issue>2</issue><spage>17</spage><epage>9</epage><pages>17-9</pages><artnum>17</artnum><issn>1357-0560</issn><issn>1559-131X</issn><eissn>1559-131X</eissn><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.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>30666496</pmid><doi>10.1007/s12032-018-1230-4</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1357-0560 |
| ispartof | Medical oncology (Northwood, London, England), 2019-02, Vol.36 (2), p.17-9, Article 17 |
| issn | 1357-0560 1559-131X 1559-131X |
| language | eng |
| recordid | cdi_osti_scitechconnect_22938450 |
| source | MEDLINE; SpringerLink Journals |
| subjects | Adult Age Aged Clinical outcomes DIAGNOSIS Female HAZARDS Hematology Humans Internal Medicine Male MEDICAL SURVEILLANCE Medicine Medicine & Public Health Melanoma Melanoma - epidemiology Melanoma - mortality Melanoma - pathology Melanoma - therapy MELANOMAS METASTASES Metastasis Middle Aged MORTALITY Oncology Original Paper Pathology PATIENTS RADIOLOGY AND NUCLEAR MEDICINE Retrospective Studies Risk Factors Surveillance SYMPTOMS Treatment Outcome Uveal Neoplasms - epidemiology Uveal Neoplasms - mortality Uveal Neoplasms - pathology Uveal Neoplasms - therapy |
| title | Risk factors, clinical outcomes, and natural history of uveal melanoma: a single-institution analysis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-29T05%3A45%3A19IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_osti_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Risk%20factors,%20clinical%20outcomes,%20and%20natural%20history%20of%20uveal%20melanoma:%20a%20single-institution%20analysis&rft.jtitle=Medical%20oncology%20(Northwood,%20London,%20England)&rft.au=Delgado-Ramos,%20Glenda%20M.&rft.date=2019-02-01&rft.volume=36&rft.issue=2&rft.spage=17&rft.epage=9&rft.pages=17-9&rft.artnum=17&rft.issn=1357-0560&rft.eissn=1559-131X&rft_id=info:doi/10.1007/s12032-018-1230-4&rft_dat=%3Cproquest_osti_%3E2179409603%3C/proquest_osti_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2169228410&rft_id=info:pmid/30666496&rfr_iscdi=true |