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Keywords = LUMPO3 model

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20 pages, 589 KB  
Article
Deferral of Treatment for Small Choroidal Melanoma and the Risk of Metastasis: An Investigation Using the Liverpool Uveal Melanoma Prognosticator Online (LUMPO)
by Bertil Damato, Antonio Eleuteri, Azzam Taktak, Rumana Hussain, Maria Fili, Gustav Stålhammar, Heinrich Heimann and Sarah E. Coupland
Cancers 2024, 16(8), 1607; https://doi.org/10.3390/cancers16081607 - 22 Apr 2024
Cited by 19 | Viewed by 3782
Abstract
Background: We estimated metastatic-death risk when the treatment of small choroidal melanomas is deferred until growth is observed. Methods: In 24 patients with choroidal melanoma (median diameter 5.85 mm), the exponential growth rate estimated by a mixed-effects model was 4.3% per year. Using [...] Read more.
Background: We estimated metastatic-death risk when the treatment of small choroidal melanomas is deferred until growth is observed. Methods: In 24 patients with choroidal melanoma (median diameter 5.85 mm), the exponential growth rate estimated by a mixed-effects model was 4.3% per year. Using the Liverpool Uveal Melanoma Prognosticator Online v.3 (LUMPO3), we measured changes in 15-year metastatic and non-metastatic death risks according to whether the tumor is treated immediately or after observing growth 4 or 12 months later, considering age, sex, and metastasis predictors. Results: In 40-year-old females with 10 mm, disomy 3 and monosomy 3 choroidal melanomas (prevalence 16%), the 15-year absolute risks of metastatic death are 4.2% and 76.6%, respectively, increasing after a 4-month delay by 0.0% and 0.2% and by 3.0% and 2.3% with tumor growth rates of 5.0% and 20.0%, respectively. With 12-month delays, these risks increase by 0.0% and 0.5% and by 1.0% and 7.1%, respectively. Increases in metastatic-death risk are less with smaller tumors and with a higher risk of non-metastatic death. Conclusions: Deferring treatment of choroidal melanomas until documentation of growth may delay iatrogenic visual loss by months or years and is associated with minimal increase in metastatic mortality, at least with small tumors with usual growth rates of up to 40% per year. Full article
(This article belongs to the Section Clinical Research in Cancer)
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14 pages, 2148 KB  
Article
A Retrospective Analysis of 10 Years of Liver Surveillance Undertaken in Uveal Melanoma Patients Treated at the Supraregional “Liverpool Ocular Oncology Centre”, UK
by Alda Cunha Rola, Helen Kalirai, Azzam F. G. Taktak, Antonio Eleuteri, Yamini Krishna, Rumana Hussain, Heinrich Heimann and Sarah E. Coupland
Cancers 2022, 14(9), 2187; https://doi.org/10.3390/cancers14092187 - 27 Apr 2022
Cited by 6 | Viewed by 2968
Abstract
Purpose: To determine liver screening frequency and modality in UM patients following primary treatment, and the characteristics of detected metastases. Methods: A 10-year retrospective study of 615 UM patients undergoing liver surveillance in Liverpool. Information was collected from liver scan reports of these [...] Read more.
Purpose: To determine liver screening frequency and modality in UM patients following primary treatment, and the characteristics of detected metastases. Methods: A 10-year retrospective study of 615 UM patients undergoing liver surveillance in Liverpool. Information was collected from liver scan reports of these patients. Results: Of 615 UM patients analyzed, there were 337 men (55%) and 278 women (45%). Median age at primary treatment was 61 years (range, 22–94). At study end, median follow-up was 5.1 years, with 375 patients (61%) alive and 240 deceased (39%). Of the deceased patients, 187 (78%) died due to metastatic UM; 24 (10%) deaths were due to other causes; and 29 (12%) patients died of unknown conditions. In total, 3854 liver scans were performed in the 615 UM patients, with a median of 6.2 scans per patient (range, 1–40). Liver MRI was most frequently performed (62.8%). In total, 229 (37%) UM patients developed metastases during the study period: 150 were detected via liver surveillance and 79 were observed post-mortem. Conclusions: Metastatic UM onset is related to the size and genetic profiles of the primary UM, and can be predicted using the model LUMPO3. Regular liver surveillance allowed for timely detection of metastases, and through metastasectomy can lead to prolongation of life in some patients. Full article
(This article belongs to the Section Cancer Causes, Screening and Diagnosis)
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13 pages, 1333 KB  
Article
Multicenter External Validation of the Liverpool Uveal Melanoma Prognosticator Online: An OOG Collaborative Study
by Alda Cunha Rola, Azzam Taktak, Antonio Eleuteri, Helen Kalirai, Heinrich Heimann, Rumana Hussain, Laura J. Bonnett, Christopher J. Hill, Matthew Traynor, Martine J. Jager, Marina Marinkovic, Gregorius P.M. Luyten, Mehmet Dogrusöz, Emine Kilic, Annelies de Klein, Kyra Smit, Natasha M van Poppelen, Bertil E. Damato, Armin Afshar, Rudolf F. Guthoff, Björn O. Scheef, Vinodh Kakkassery, Svetlana Saakyan, Alexander Tsygankov, Carlo Mosci, Paolo Ligorio, Silvia Viaggi, Claudia H.D. Le Guin, Norbert Bornfeld, Nikolaos E. Bechrakis and Sarah E. Couplandadd Show full author list remove Hide full author list
Cancers 2020, 12(2), 477; https://doi.org/10.3390/cancers12020477 - 18 Feb 2020
Cited by 57 | Viewed by 5562
Abstract
Uveal melanoma (UM) is fatal in ~50% of patients as a result of disseminated disease. This study aims to externally validate the Liverpool Uveal Melanoma Prognosticator Online V3 (LUMPO3) to determine its reliability in predicting survival after treatment for choroidal melanoma when utilizing [...] Read more.
Uveal melanoma (UM) is fatal in ~50% of patients as a result of disseminated disease. This study aims to externally validate the Liverpool Uveal Melanoma Prognosticator Online V3 (LUMPO3) to determine its reliability in predicting survival after treatment for choroidal melanoma when utilizing external data from other ocular oncology centers. Anonymized data of 1836 UM patients from seven international ocular oncology centers were analyzed with LUMPO3 to predict the 10-year survival for each patient in each external dataset. The analysts were masked to the patient outcomes. Model predictions were sent to an independent statistician to evaluate LUMPO3’s performance using discrimination and calibration methods. LUMPO3’s ability to discriminate between UM patients who died of metastatic UM and those who were still alive was fair-to-good, with C-statistics ranging from 0.64 to 0.85 at year 1. The pooled estimate for all external centers was 0.72 (95% confidence interval: 0.68 to 0.75). Agreement between observed and predicted survival probabilities was generally good given differences in case mix and survival rates between different centers. Despite the differences between the international cohorts of patients with primary UM, LUMPO3 is a valuable tool for predicting all-cause mortality in this disease when using data from external centers. Full article
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