PURPOSE. High expression levels of insulin-like growth factor-1 (IGF-1) receptor were associated with metastatic uveal melanoma (UM). The purpose of this study was to examine the potential of serum IGF-1 in early detection of liver metastasis.METHODS. IGF-1 serum levels were analyzed using enzymelinked immunosorbent assay for 118 subjects in three different groups: 55 disease-free (DF) UM patients who did not develop metastasis within 10 years of diagnosis; 22 metastatic patients; and 41 healthy subjects. Matched pairs univariate analysis was performed for sera of 19 metastatic patients 12 and 6 months before the diagnosis of metastasis and on the day of diagnosis, both as time groups and normalized levels per patient. IGF-1 levels were compared among groups by analysis of variance and Student t-test.
RESULTS.Mean 6 SD IGF-1 serum levels for the control, DF, and metastatic groups were 152.48 6 49.76, 119.92 6 60.66, and 96.99 6 56.91 ng/mL, respectively (P < 0.001). Normalized changes in IGF-1 per metastatic patient from 6 months prior to the diagnosis of metastases compared to the day of diagnosis of metastases showed a decreasing trend.CONCLUSIONS. IGF-1 levels in 10-years' disease-free UM patients were significantly lower than those in healthy subjects and were even lower in metastatic patients. IGF-1 levels decreased toward the diagnosis of metastases. Therefore, serum IGF-1 level may be used as a predictive biomarker for metastatic UM when measured repeatedly. (Invest Ophthalmol Vis Sci. 2013; 54:490-493) DOI:10.1167/iovs.12-10228 U veal melanoma (UM) is the most common primary intraocular malignant tumor in adults, 1 albeit a rare tumor with a mean age-adjusted incidence in the United States of 5.1 per million, representing only 3.1% of all recorded cases of melanoma.2 The liver is the predominant metastatic organ, and in the collaborative ocular melanoma study (COMS), the liver was involved in 89% of cases.
3Brachytherapy and external irradiation (proton beam, stereotactic radiosurgery, or gamma knife) are the most common treatment options for small-to medium-sized tumors, with a success rate of approximately 90%, while enucleation remains the common treatment for large tumors. Despite the high success rate in treating the primary tumors, the 5-and 10-year cumulative rates for developing metastases are 25% and 34%, respectively, with 80% of the metastatic patients dying within 1 year and 92% within 2 years of the diagnosis of metastases. 4 However, metastases have been diagnosed even more than 40 years from enucleation.5 These findings led to the hypothesis that micrometastases had already been seeded at the time of diagnosis and developed over time as a result of unknown factors until metastatic disease was diagnosed. 6 Currently there is no adjuvant chemotherapy to eliminate micrometastases, and treatments for overt metastatic disease are of limited value except for a subgroup of patients who are diagnosed early enough to allow complete surgical resection of liver metastases. 7,8 Liver resection may inc...