Objective: To assess the association of skin color using Fitzpatrick Skin Type (FST) with metastatic risk of uveal melanoma.
Subjects: 854 consecutive patients with uveal melanoma and documented FST
Methods: Retrospective detailed review of patient charts was performed for FST (type I- white, II-fair, III-average, IV-light brown, V-brown, VI-black), clinical details of the patient and the uveal melanoma, tumor cytogenetic classification according to The Cancer Genome Atlas (TCGA), and outcome of melanoma-related metastasis and death.
Results: The FST classification was type I (n=97 patients), type II (n=665), type III (n=79), type IV (n=11), type V (n=2), type VI (n=0). A comparison of patient FST (type I vs. II vs. III-V) revealed significant differences in mean age at presentation (64.1 vs. 58.5 vs. 49.8 years, p<0.001), race white (100% vs. 98% vs. 75%, p<0.001), presence of ocular melanocytosis (3% vs. 3% vs. 10%, p=0.01), visual acuity <20/200 at presentation (6% vs. 7% vs. 13%, p=0.03), genetic results showing TCGA group B tumors (11% vs. 14% vs. 26%, p=0.01) or TCGA group D tumors (22% vs. 11% vs. 9%, p=0.01), 10-year incidence of melanoma-related metastasis (25% vs. 15% vs. 14%, p=0.02) and 10-year incidence of melanoma-related death (9% vs. 3% vs. 4%, p=0.04). FST was a significant predictor of melanoma-related metastasis (p=0.02, Hazard ratio 2.3).
Conclusions: Fitzpatrick skin type may be a predictor of melanoma-related metastasis, with metastasis and TCGA Group D tumors being more common in patients with FST I.
