Survival analysis of patients with uveal melanoma after organ preserving and liquidation treatment

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Rationale: Uveal melanoma is the most common primary malignancy of the eye.

Aim: To evaluate survival in patients with uveal melanoma stratified according to the type of treatment and to identify factors significantly associated with their survival.

Materials and methods: The study was performed on the data extracted from medical files and follow-up forms of patients with uveal melanoma seen in the Ophthalmological Clinical Hospital of the Department of Healthcare, Moscow, from 1977 to 2012. Analysis of survival was used to assess the life longevity of patients with uveal melanoma. The analysis was censored at January 2013, when vital status (dead or alive) of all patients was assessed. The factors included into the study analysis, were those taken from the follow-up forms. The incidence of uveal melanoma in Moscow (2012) was 0.9 per 100,000 of the population, whereas its prevalence was 11.1 per 100,000.

Results: 698 patients with uveal melanoma were included into the study, among them 260 (37%) men (aged from 19 to 87 years, median age 60 years) and 438 (63%) women (aged from 18 to 93 years, median age 63 years); therefore, the proportion of women under the follow-up monitoring was by 26% higher than that of men. The liquidation treatment (mostly enucleation) was performed in 358 (51%) of the patients, whereas the organ preserving treatment in 340 (49%). At 5, 7, and 10 years of the follow-up, the disease-specific survival of patients with uveal melanoma after the organ preserving treatment (median survival has not been reached) and after the liquidation treatment (median, 88 months) were 89 ± 2, 83 ± 3, and 75 ± 4% versus 63 ± 3, 52 ± 4, and 47 ± 5%, respectively (р = 0.001). Overall survival and disease-specific survival of the patients after the liquidation treatment were significantly lower than in the patients after the organ-preserving treatment. According to multiple regression analysis, this was associated not with the type of treatment, but rather with higher initial grade of the disease (as the most significant factor) and with older age (> 65 years; the second significant factor). Both factors were significantly more prevalent (р = 0.05; chi-square test) among the patients who underwent the liquidation treatment.

Conclusion: The large size of the uveal melanoma, with its pre-equator location and extrascleral spread, as well as the age above 65 years can be considered as unfavorable prognostic factors.

About the authors

E. E. Grishina

Moscow Regional Research and Clinical Institute (MONIKI)

Author for correspondence.

Elena E. Grishina – MD, PhD, Professor, Leading Research Fellow, Ophthalmology Department.

61/2–11 Shchepkina ul., Moscow, 129110, +7 (905) 703 18 63

Russian Federation

M. Yu. Lerner

City Clinical Hospital named after S.P. Botkin (Moscow)


Marina Yu. Lerner – MD, PhD, Director of the Moscow Municipal Center of Ophthalmic Oncology.

7 Mamonovskiy pereulok, Moscow, 123001

Russian Federation

E. G. Gemdzhian

National Research Center for Hematology


Eduard G. Gemdzhian – Senior Research Fellow, Biostatistics Laboratory.

Novyy Zykovskiy proezd, Moscow, 125167

Russian Federation


  1. Бровкина АФ, ред. Офтальмоонкология. М.: Медицина; 2002. 424 с.
  2. McLaughlin CC, Wu XC, Jemal A, Martin HJ, Roche LM, Chen VW. Incidence of noncutaneous melanomas in the U.S. Cancer. 2005;103(5): 1000–7. doi: 10.1002/cncr.20866.
  3. Singh AD, Topham A. Incidence of uveal melanoma in the United States: 1973–1997. Ophthalmology. 2003;110(5): 956–61. doi: 10.1016/S0161-6420(03)00078-2.
  4. Зиангирова ГГ, Лихванцева ВГ. Опухоли сосудистого тракта глаза. М.: Последнее слово; 2003. 455 с.
  5. Гришина ЕЕ, Лернер МЮ, Гемджян ЭГ. Эпидемиология увеальной меланомы в Москве. Альманах клинической медицины. 2017;45(4): 321–5. doi: 10.18786/2072-05052017-45-4-321-325.
  6. Бровкина АФ, Вальский ВВ, Гусев ГА, Пантелеева ОГ, Юровская НН. Риск метастазирования меланом хориоидеи после брахитерапии. Вестник офтальмологии. 2003;119(2): 26–8.
  7. Vicente N, Saornil MA, García-Álvarez C, Almaraz A, Alonso Martínez P, Frutos-Baraja JM, López-Lara F. Uveal melanoma: clinical characteristics, treatment and survival in a series of 500 patients. Arch Soc Esp Oftalmol. 2013;88(11): 433–8. doi: 10.1016/j.oftal.2013.06.003.
  8. Панова ИЕ, Пилат АВ, Бухтиярова НВ, Семенова ЛЕ, Важенина ДА, Ушенина ЛА. Многокомпонентное лечение увеальной меланомы. Офтальмохирургия. 2007;(2): 24–7.
  9. Бровкина АФ. Современные аспекты лечения меланом хориоидеи: проблемы, дискуссионные вопросы. Вестник офтальмологии. 2006;122(1): 13–6.
  10. Sagus M, Bedikian AY. Uveal melanoma in the first 4 decades of life. South Med J. 2015;108(3): 158–63. doi: 10.14423/SMJ.0000000000000248.
  11. Jancar B, Budihna M, Drnovsek-Olup B, Andrejcic KN, Zupancic IB, Pahor D. Prognostic factors of choroidal melanoma in Slovenia, 1986–2008. Radiol Oncol. 2016;50(1): 104–12. doi: 10.1515/raon-2015-0009.
  12. Andreoli MT, Mieler WF, Leiderman YI. Epidemiological trends in uveal melanoma. Br J Ophthalmol. 2015;99(11): 1550–3. doi: 10.1136/bjophthalmol-2015-306810.
  13. Chew AL, Spilsbury K, Isaacs TW. Survival from uveal melanoma in Western Australia 1981– 2005. Clin Exp Ophthalmol. 2015;43(5): 422–8. doi: 10.1111/ceo.12490.
  14. Zimmerman LE, McLean IW, Foster WD. Does enucleation of the eye containing a malignant melanoma prevent or accelerate the dissemination of tumour cells. Br J Ophthalmol. 1978;62(6): 420–5. doi: 10.1136/bjo.62.6.420.
  15. Singh AD, Rennie IG, Kivela T, Seregard S, Grossniklaus H. The Zimmerman-McLean-Foster hypothesis: 25 years later. Br J Ophthalmol. 2004;88(7): 962–7. doi: 10.1136/bjo.2003.029058.
  16. Collaborative Ocular Melanoma Study Group. The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma: V. Twelve-year mortality rates and prognostic factors: COMS report No. 28. Arch Ophthalmol. 2006;124(12): 1684–93. doi: 10.1001/archopht.124.12.1684.
  17. Furdova A, Slezak P, Chorvath M, Waczulikova I, Sramka M, Kralik G. No differences in outcome between radical surgical treatment (enucleation) and stereotactic radiosurgery in patients with posterior uveal melanoma. Neoplasma. 2010;57(4): 377–81. doi: 10.4149/neo_2010_04_377.
  18. Gambrelle J, Grange JD, Devouassoux Shisheboran M, Rivoire M, Baggetto LG, Jean-Louis B, Fleury J, Kodjikian L. Survival after primary enucleation for choroidal melanoma: changes induced by the introduction of conservative therapies. Graefes Arch Clin Exp Ophthalmol. 2007;245(5): 657–63. doi: 10.1007/s00417-006-0477-1.
  19. Krohn J, Monge OR, Skorpen TN, Mørk SJ, Dahl O. Posterior uveal melanoma treated with I-125 brachytherapy or primary enucleation. Eye (Lond). 2008;22(11): 1398–403. doi: 10.1038/sj.eye.6702911.
  20. Саакян СВ, Пантелеева ОГ, Ширина ТВ. Оценка выживаемости больных увеальной меланомой после органосохранного лечения и энуклеации. Российский офтальмологический журнал. 2011;(1): 67–70.
  21. Саакян СВ, Пантелеева ОГ, Ширина ТВ. Особенности метастатического поражения и выживаемости больных с увеальной меланомой в зависимости от метода проведенного лечения. Российский офтальмологический журнал. 2012;5(2): 55–8.
  22. Яровой АА, Магарамов ДА. Меланома хориоидеи стадии Т2 высотой более 6,0 мм: органосохраняющее лечение с использованием брахитерапии и транспупиллярной термотерапии или энуклеация? Анализ выживаемости. Вестник офтальмологии. 2011;127(1): 43–5.
  23. Стоюхина АС, Чесалин ИП. Выживаемость больных меланомой хориоидеи больших размеров. Вестник офтальмологии. 2014;130(4): 39–44.
  24. Melia M, Moy CS, Reynolds SM, Hayman JA, Murray TG, Hovland KR, Earle JD, Kurinij N, Dong LM, Miskala PH, Fountain C, Cella D, Mangione CM; Collaborative Ocular Melanoma Study-Quality of Life Study Group. Quality of life after iodine 125 brachytherapy vs enucleation for choroidal melanoma: 5-year results from the Collaborative Ocular Melanoma Study: COMS QOLS Report No. 3. Arch Ophthalmol. 2006;124(2): 226–38. doi: 10.1001/archopht.124.2.226.
  25. Бровкина АФ, Стоюхина АС, Чесалин ИП. Метрическая классификация меланом хориоидеи и ее роль в выборе лечения. Вестник офтальмологии. 2016;132(2): 4–7. doi: 10.17116/oftalma201613224-7.
  26. Krantz BA, Dave N, Komatsubara KM, Marr BP, Carvajal RD. Uveal melanoma: epidemiology, etiology, and treatment of primary disease. Clin Ophthalmol. 2017;11:279–89. doi: 10.2147/OPTH.S89591.
  27. Shields CL, Kaliki S, Furuta M, Fulco E, Alarcon C, Shields JA. American Joint Committee on Cancer Classification of Uveal Melanoma (Anatomic Stage) Predicts Prognosis in 7,731 Patients: The 2013 Zimmerman Lecture. Ophthalmology. 2015;122(6): 1180–6. doi: 10.1016/j.ophtha.2015.01.026.
  28. Mahendraraj K, Lau CS, Lee I, Chamberlain RS. Trends in incidence, survival, and management of uveal melanoma: a population-based study of 7,516 patients from the Surveillance, Epidemiology, and End Results database (1973– 2012). Clin Ophthalmol. 2016;10:2113–9. doi: 10.2147/OPTH.S113623.
  29. Singh AD, Turell ME, Topham AK. Uveal melanoma: trends in incidence, treatment, and survival. Ophthalmology. 2011;118(9): 1881–5. doi: 10.1016/j.ophtha.2011.01.040.
  30. Kaliki S, Shields CL, Shields JA. Uveal melanoma: estimating prognosis. Indian J Ophthalmol. 2015;63(2): 93–102. doi: 10.4103/03014738.154367.
  31. Onken MD, Worley LA, Char DH, Augsburger JJ, Correa ZM, Nudleman E, Aaberg TM Jr, Altaweel MM, Bardenstein DS, Finger PT, Gallie BL, Harocopos GJ, Hovland PG, McGowan HD, Milman T, Mruthyunjaya P, Simpson ER, Smith ME, Wilson DJ, Wirostko WJ, Harbour JW. Collaborative Ocular Oncology Group report number 1: prospective validation of a multi-gene prognostic assay in uveal melanoma. Ophthalmology. 2012;119(8): 1596–603. doi: 10.1016/j.ophtha.2012.02.017.
  32. Shields CL, Say EAT, Hasanreisoglu M, Saktanasate J, Lawson BM, Landy JE, Badami AU, Sivalingam MD, Mashayekhi A, Shields JA, Ganguly A. Cytogenetic abnormalities in uveal melanoma based on tumor features and size in 1059 patients: The 2016 W. Richard Green lecture. Ophthalmology. 2017;124(5): 609–18. doi: 10.1016/j.ophtha.2016.12.026.
  33. Rao YJ, Sein J, Badiyan S, Schwarz JK, DeWees T, Grigsby P, Rao PK. Patterns of care and survival outcomes after treatment for uveal melanoma in the post-coms era (2004–2013): a surveillance, epidemiology, and end results analysis. J Contemp Brachytherapy. 2017;9(5): 453–65. doi: 10.5114/jcb.2017.70986.

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Copyright (c) 2018 Grishina E.E., Lerner M.Y., Gemdzhian E.G.

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