Comprehensive causes of death in uveal melanoma: mortality in 1530 consecutively diagnosed patients followed until death

Abstract

Background Uveal melanoma has a high propensity for metastatic spread. Yet, the comprehensive causes of death in a large consecutive cohort followed from diagnosis to death remain unknown. Methods All Swedish patients diagnosed with melanoma involving the iris, choroid, and/or ciliary body after January 1st, 1960, were assessed for this study. Sequential inclusion was halted upon encountering the first surviving patient during data collection. Causes of death were collected from the National Cause of Death Registry and audited by analysis of up to 15 causative diagnoses. Results A total of 1530 patients were included, each histopathologically verified with primary uveal melanoma. Mortality from metastatic uveal melanoma was 31% at 5 years, 40% at 10 years, 45% at 20 years, 47% at 30 years, and 48% between 40 to 60 years post-diagnosis. Notably, the longest period between diagnosis and metastatic fatality was 49.6 years. Additionally, 186 other causes of death were recorded, with cardiovascular diseases constituting 26%, other cancers 10%, stroke 6%, dementias 2%, and lower respiratory infections 2% of total mortalities. Mortality from colorectal, lung, prostate, and stomach carcinomas over 60 years were 1.4%, 1.4%, 1.2%, and 0.9%, with metastatic uveal melanoma being the leading cumulative and annual cause of death for the initial 41- and 5-years post-diagnosis, respectively. Conclusions In this large consecutive cohort, half of the included patients ultimately succumbed to metastatic uveal melanoma, with deaths occurring up to 50 years after diagnosis. One quarter and one tenth of patients died from cardiovascular diseases and other cancers, respectively.

Development and Validation of a Deep Learning Algorithm for Differentiation of Choroidal Nevi from Small Melanoma in Fundus Photographs

“…1,2 In contrast, uveal melanomas, while rare, are associated with a high risk for metastatic death. 3,4 Separating the two can be a considerable challenge.…”