Prognostic Factors and Nomograms for Overall and Cancer-Specific Survival of Patients with Uveal Melanoma without Metastases: A SEER Analysis of 4119 Cases

Abstract

Purpose. To determine prognostic factors for patients with uveal melanoma without metastases and to construct nomograms to predict their 3- and 5-year overall survival (OS) and cancer-specific survival (CSS). Methods. We included 4119 patients who were registered from 2004 to 2015 in the Surveillance, Epidemiology, and End Results database. The median follow-up time was 5.8 years. Independent risk factors affecting OS and CSS were identified with univariate and multivariate Cox regression analyses and used to construct nomograms. Internal and external validation were carried out by using the bootstrap method to calculate the concordance indices (C-indices) and plot the calibration curves. Results. Age, primary site, histological type, T-stage, and treatment were independent risk factors for OS and CSS; marital status and sequence number were factors only for OS. The C-indices for internal validation of OS and CSS were 0.713 (95% CI, 0.697–0.729) and 0.708 (95% CI, 0.688–0.728), respectively, and for external validation they were 0.729 (95% CI, 0.705–0.753) and 0.731 (95% CI, 0.700–0.762), respectively. The calibration curves also revealed good agreement between the predicted and actual survival rates. Conclusions. We constructed nomograms to predict the 3- and 5-year OS and CSS of patients with uveal melanoma without metastases. Our nomograms may improve prognostication and assist with the development of individualized treatment strategies.

A prognostic nomogram for the cancer-specific survival rate of choroidal melanoma using the Surveillance, Epidemiology, and End Results database

“…Surprisingly, our study found that surgery was an adverse risk factor. Jang et al ( 35 ) and Liu et al ( 9 ) reported that patients treated with surgery showed an overall worse survival rate than those treated with radiotherapy. One possible explanation is that surgery was performed only in cases with large CM, with CM surrounding the optic nerve, or suspected extraocular extension ( 36 ).…”

“…AJCC staging was conducted following the guidelines of the 6th edition of the AJCC staging system (2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015). The technique of integrating histologic subtypes of patients with choroidal melanoma is based on the criterion of Liu et al (9). Therefore, we have merged the NOS group and the other group (achromic melanoma, desmoplastic melanoma and nodular melanoma) into a unified group.…”

“…Presently, several studies have adopted a comprehensive approach, considering all locations of uveal melanoma within one cohort to analyze the prognostic factors (9)(10)(11). Nevertheless, prior research has put forth new evidence potentially correlating the survival outcomes with the specific location of the primary tumor.…”