Construction of a nomogram for predicting the RFS and OS in patients with uveal melanoma: A retrospective cohort study

Abstract

Purpose : Stratification of patients with uveal melanoma into classes of risk for metastatic disease is mandatory for survjeillance decisions and enrollment into adjuvant systemic therapies. Our study aimed to develop a nomogram to predict RFS (Recurrence Free Survival ) and OS (Overall survival) in patients with advanced stage of uveal melanoma (UM).

Methods : A retrospective analysis was performed in 100 primary UM cases treated with primary ( 92%) or secondary(8%) enucleation at Fondazione Policlinico Gemelli Rome between 2008 and 2019. Metastasis status, time to metastasis and additional clinical informations were collected based on retrospective chart review. High resolution a-CGH was performed on genomic DNA from cancer cells and form peripheral blood cells. Histopatology and clinical staging of the tumor were simultaneously assessed.

Results : The mean age was 61.5 years; mean tumor thickness was equal to 9.7 ±3.2 mm, largest basal diameter 16 mm (IQR 13.9-18.0). Extraocular extension was observed in 11% of cases, ciliary body in the 35%. Monosomy 3 was found in 55% of patients whilst duplication and amplification of the 8q, as well as 6p duplication were observed in one third of patients. Less prevalent were instead 8p, 1p and 16q deletions, with a range between the 23% and 28%. Over half of patients (57%) experienced either a recurrence or a metastasis or both, with these latter largely prevalent (53% of the whole sample), with a median RFS of 43.1 months. Likewise, also mortality rate was high, with a prevalence of 50%, and a median OS of 54.7 months.
From the nomogram plotted for the probability of 6months, 1,3 and 5 years RFS, the highest contribution was provided by extraocular extension, followed by an 8p and 1p losses. The nomogram plotted for the probability of 6-months, 1-3-5 years OS disclosed that the highest contribution was provided by age and the largest basal diameter of the tumor, followed, among chromosomic alterations, by 1p loss and 8p and 16q losses.

Conclusions : Prognostic nomogram may contribute to assist clinicians in surveillance and clinical decision making .

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.