March 2012
Volume 53, Issue 14
Free
ARVO Annual Meeting Abstract  |   March 2012
Liver Function Tests Are Not Relevant For Early Detection Of Liver Metastasis Of Uveal Melanoma
Author Affiliations & Notes
  • Frederic Mouriaux
    Ophthalmology,
    Centre Hospitalier Univ of Caen, Caen, France
  • Caroline Diorio
    URESP, Centre de recherche FRSQ du CHA, Québec, Quebec, Canada
  • Dan Bergeron
    URESP, Centre de recherche FRSQ du CHA, Québec, Quebec, Canada
    Centre Universitaire d'Ophtalmologie, Québec, Quebec, Canada
  • Celia Berchi
    ERI3 INSERM Cancers & Populations,
    Centre Hospitalier Univ of Caen, Caen, France
    Centre Universitaire d'Ophtalmologie, Québec, Quebec, Canada
  • Alain Rousseau
    Centre Universitaire d'Ophtalmologie, Québec, Quebec, Canada
  • Footnotes
    Commercial Relationships  Frederic Mouriaux, None; Caroline Diorio, None; Dan Bergeron, None; Celia Berchi, None; Alain Rousseau, None
  • Footnotes
    Support  Fond dédiés en Ophtalmologie, Hôpital du St Sâcrement, Québec, Canada
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 3421. doi:
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      Frederic Mouriaux, Caroline Diorio, Dan Bergeron, Celia Berchi, Alain Rousseau; Liver Function Tests Are Not Relevant For Early Detection Of Liver Metastasis Of Uveal Melanoma. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3421.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : Study the relevance of liver function tests (LFTs) for early detection of liver metastasis of uveal melanoma.

Methods: : We included 88 patients who developed metastasis while undergoing semi-annual follow-up with LFTs including aspartate-aminotransferase (AST), alanine-aminotransferase (ALT), gammaglutamyltransferase (γGT), lactodeshydrogenase (LDH), and phosphatase alkaline (PA). As controls, we used 174 patients with uveal melanoma who did not develop metastasis.The diagnostic attributes of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each test were estimated from cross-tabulation tables of test results according to the diagnosis of metastasis. The proportions of false positives between groups of patients with and without metastasis were compared in log-binomial regression models

Results: : Metastases were detected after LFT abnormality (at least one abnormal test) in 40 (45%) patients. The overall sensitivity of LFTs ranged from 12.5% to 58.0% and the predictive positive value (PPV) from 9.4% to 38.6%. The overall specificity and NPV were ≥ 90%. The proportions of false positive between groups of patients with and without metastasis did not differ significantly (all p-values ≥ 0.38). Using a cost evaluation, we calculated that semi-annual screening by LFTs costs 35.5 $/year/patient, including liver imaging induced by true and false positives.

Conclusions: : Isolated or combined LFTs for AST, ALT, γGT, LDH, and PA are not relevant for detection of early metastasis. Given the high NPV, if the LFTs are normal, LFT screening allows us only to reassure the patient

Keywords: melanoma • uvea • oncology 
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