1140P - Metastatic uveal melanoma: a 22 years single center experience

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Melanoma and other Skin Tumours
Presenter Sara Valpione
Authors S. Valpione1, C. Aliberti2, J. Pigozzo3, E. Midena4, R. Parrozzani4, S. Stragliotto5, P.L. Pilati6, L.G. Campana1, V. Chiarion Sileni7
  • 1Istituto Oncologico Veneto IRCCS, 35128 - Padova/IT
  • 2Interventional Radiology, Istituto Oncologico Veneto IRCSS, Padova, Italy, 35128 - Padova/IT
  • 3U.o.oncologia Medica, Istituto Oncologico Veneto IRCCS, 35128 - Padova/IT
  • 4Department Of Ophthalmology, University of Padova, 35128 - Padova/IT
  • 5Medical Oncology Ii, Istituto Oncologico Veneto IRCCS, 35128 - Padova/IT
  • 6Gastroenterological And Surgical Sciences, University of Padova, 35128 - Padova/IT
  • 7Medical Oncology, Istituto Oncologico Veneto IRCCS, 35128 - Padova/IT

Abstract

Uveal melanoma (UM) is the most frequent eye cancer (annual incidence 0.5-0.7:100000), 40% to 60% of patients develop metastases; of them, up to 95% experience liver involvement. Metastatic disease carries a poor prognosis and no standard therapy is established so far. We retrospectively reviewed the medical records of 127 consecutive patients (M/F:61/65) with metastatic UM treated at our institution from September 1990 to February 2012. We collected: gender, age, TNM stage, data and site of primary UM and metastases; LDH, alkaline phosphatase, gGT, transaminases; treatments and outcome. Mean age at diagnosis of primary UM was 56.4 years (median 59.8, 95% CI 53.7-59.1 years). Mean age at diagnosis of first metastasis was 58.8 years (median 62.4, 95% CI 56.1-61.5 years), with a mean disease-free interval (DFI) of 3.6 years (median 1.9, 95% CI 1.9-5.3 years). Ninetynine (78%) patients had liver metastases (LM), 28 (22%) had local or nodal involvement, 9 (7.1%) had lung metastases and 13 (10.2%) had other visceral metastases (CNS, kidney, spleen, adrenal gland, bone), 30 (23.6%) patients had multiple sites of disease. Lung metastases were more frequent in females (OR 9.17, 95% CI 1.11-75.96, p = 0.037). LDH and gGT levels at the first metastasis onset, were inversely correlated with survival (p < 0.05). Survival was significantly poorer in LM bearers (13% versus 55% 1 year survival, p < 0.01). Longer DFI was a prognostic factor for not hepatic recurrence and better prognosis (logistic regression, OR 0.88, 95% CI 0.78-0.99, p < 0.05). Age at diagnosis correlated with age at recurrence and with longer DFI (p < 0.05). Considering all treatments, almost always combining locoregional and systemic therapy with fotemustine, [hepatic intra-arterial fotemustine, radiofrequency, alcoholization, surgery, intra-arterial hepatic chemoembolization with camptothecin charged microbeads (TACE)], only TACE was associated with an improved prognosis (OR 0.17, 95% CI 0.06-0.46, p < 0.01) and with a longer survival after metastasis diagnosis (p= 0.02).

Conclusions

TACE can be combined with systemic therapy and provides a clinical benefit in UM metastases, this encourages further prospective studies, also in combination with anti-angiogenic drugs and systemic therapies.

Disclosure

All authors have declared no conflicts of interest.