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Zaynab Sajjadi, Zeynep Bas, Eileen L. Mayro, Arupa Ganguly, Carol Shields; Outcomes of The Cancer Genome Atlas (TCGA) Classification in Uveal Melanoma by Patient Age in 1001 Eyes. Invest. Ophthalmol. Vis. Sci. 2021;62(8):40.
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The Cancer Genome Atlas (TCGA) is a genetic based classification of 33 types of cancer including uveal melanoma and is highly predictive of uveal melanoma-related metastasis and death. We performed a retrospective, cohort study to evaluate TCGA classification and outcomes for uveal melanoma based on patient age at presentation.
Retrospective analysis of patients with uveal melanoma at a single ocular oncology center treated with plaque radiotherapy or enucleation from 1998 to 2020 and who completed genetic testing of chromosome 3 and 8 after fine needle aspiration biopsy. Patients were classified by age group (<21 years vs. 21-40 years vs. 41-60 years vs. >60 years) at presentation. Categorical variables were compared using χ2 tests or Fisher’s exact tests. Kaplan-Meier analysis was performed for metastasis (liver metastasis, any metastasis) and death from uveal melanoma.
Of 1001 eyes with uveal melanoma, 9 (1%) were <21 years, 104 (10%) were 21-40 years, 420 (42%) were 41-60 years and 468 (47%) were >60 years of age at presentation. By comparison, the older age group had higher frequency of class D tumor (0% vs. 4% vs. 10% vs. 14%, p<0.001) and greater tumor basal diameter (11.6 vs. 12.0 vs. 11.7 vs. 12.6, p=0.02) and the younger age group had higher frequency of 20/400-no light perception (NLP) vision (56% vs. 8% vs. 8% vs. 11%, p<0.001). By Kaplan-Meier analysis (10 years), the older age group had higher rate of liver metastasis (0% vs. 14% vs. 11% vs. 14%, p=0.017), any metastasis (0% vs. 14% vs. 12% vs. 14%, p=0.033), and uveal melanoma-related death (0% vs. 2% vs. 1% vs. 3%, p=0.049).
Uveal melanoma diagnosis at an older age is associated with more advanced TCGA classification, larger tumor size, and higher metastasis and death rate.
This is a 2021 ARVO Annual Meeting abstract.
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