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Mehmet Dogrusoz, Mette Bagger, Sjoerd G. van Duinen, Wilma G. M. Kroes, Stefan Bohringer, Gregorius P. M. Luyten, Jens F Kiilgaard, Martine J Jager; AJCC Staging and Chromosome 3 and 8 status complement each other regarding prognostic value in Uveal Melanoma. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5898.
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© ARVO (1962-2015); The Authors (2016-present)
The chromosomal status as well as the anatomic extent (American Joint Committee on Cancer (AJCC) staging system), can be used to predict prognosis in uveal melanoma (UM). However, the joint effect of the chromosomal status and the anatomic extent on prognostication in UM remains unclear. We hypothesize that combining information on the chromosome 3 and 8 status and the AJCC stage improves prognostication in UM.
We performed an international retrospective cohort study, including 504 patients treated for UM in two different centers (Leiden University Medical Center, The Netherlands & Copenhagen University Hospital, Denmark) between 1999 and 2015. The median follow-up time was 35 months.The chromosome 3 and 8 status and the AJCC stage of the tumors were the parameters of interest. Kaplan-Meier survival curves were generated for different combinations of chromosome status and AJCC stage. Death due to UM metastases was chosen as the event and log-rank tests were computed.
In patients with an AJCC stage I tumor, only those with a monosomy 3 as well as chromosome 8 gain died due to UM metastases (p=0.002) (Figure 1A). In stage II tumors, patients with a monosomy 3 as well as chromosome 8 gain had the worst prognosis, while the survival of those with either a normal chromosomal status or only monosomy 3 or chromosome 8 gain was intermediate and comparable (p<0.001) (Figure 1B). The same pattern was observed in stage III tumors (p<0.001) (Figure 1C).In patients with a normal chromosomal status, none with a stage I tumor died due to metastases, while some deaths occurred in those with stage II and stage III tumors (Figure 1D). The same applied to patients with either a monosomy 3 or chromosome 8 gain (p=0.09) (Figure 1E). In tumors with the genetically worst profile, monosomy 3 as well as chromosome 8 gain, many deaths occurred in stage I and stage II tumors, while those with a stage III tumor had a clearly worse survival (p<0.001) (Figure 1F).
Combining information on the chromosome 3 and 8 status and AJCC stage improves prognostication in UM. These prognostic measures are complementary and combining them provides further stratification of survival, allowing for a more accurate prognostication.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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