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Amy C Schefler, Duncan Berry, Michael Seider, Sandra Stinnett, Prithvi Mruthyunjaya; Ocular Oncology Study Consortium Report 3: Baseline clinical features and relationship to GEP Class. Invest. Ophthalmol. Vis. Sci. 2017;58(8):2501.
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© ARVO (1962-2015); The Authors (2016-present)
To study the relationship between clinical features and Collaborative Ocular Melanoma Study (COMS)-based size categorization of gene expression profile (GEP) sub-classifications in a multi-center cohort of uveal melanoma (UM) patients.
This was a retrospective, multi-center study with patients entered from 9 major ocular oncology centers from across the United States. Eligible patients had UM and underwent I-125 plaque brachytherapy with concurrent tumor biopsy with GEP testing between January 1, 2010 and October 28, 2014. Clinical and genomic data were collected and statistical analysis was performed using Fisher’s exact test, Wilcoxon rank sum test and Kruskal-Wallis test.
Inclusion criteria were met for 379 patients. Class 2 tumors had a significantly larger baseline tumor height (p<0.001) and basal diameter (p<0.001) and were more likely to have ciliary body involvement (p=0.007) and exudative retinal detachment (p<0.001). There was no statistically significant difference between Class 1 and Class 2 tumors based on the presence of lipofuscin, drusen or subretinal fluid. Class 1a tumor patients, compared to Class 1b, were significantly older (p=0.034). However, Class 1b tumors had a non-significant trend towards larger baseline tumor height and basal tumor diameters compared to Class 1a. Class 2 tumors, when compared to Class 1b, were associated with increasing patient age (p<0.001), larger tumor height (p=0.010), ciliary body involvement (p=0.001), exudative RD (p=0.024), and anterior tumor location (p<0.001). When the tumors were grouped by COMS size categories, increasing tumor size category was significantly associated with Class 2 status: 19% of small tumors, 33% of medium tumors and 46% of large tumors were Class 2 (p=0.009).
Our findings confirm the previously reported associations between Class 2 status and increasing age, tumor height, largest basal diameter and ciliary body involvement. We are the first to report the differences in clinical features between the GEP sub-classes and our findings support the current molecular model of UM. When the tumors were grouped by size category, the distribution of the GEP sub-classes among the size groups was similar to reported time-to-metastasis data among the same size groupings.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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