Ten-year outcomes of uveal melanoma based on The Cancer Genome Atlas (TCGA) classification in 1001 cases.

Abstract

Purpose:

To understand the prognostic value of The Cancer Genome Atlas (TCGA) for uveal melanoma metastasis, using a simplified 4-category classification, based on tumor DNA.

Methods:

A retrospective cohort study of 1001 eyes with uveal melanoma at a single center, categorized according to TCGA as Group A, B, C, or D (by fine-needle aspiration biopsy for DNA analysis), and treated with standard methods, was studied for melanoma-related metastasis at 5 and 10 years.

Results:

Of 1001 eyes with uveal melanoma, the TCGA categories included Group A (n = 486, 49%), B (n = 141, 14%), C (n = 260, 26%), and D (n = 114, 11%). By comparison, increasing category (A vs. B vs. C vs. D) was associated with features of older age at presentation (56.8 vs. 52.8 vs. 61.1 vs. 63.5 years, P < 0.001), less often visual acuity of 20/20-20/50 (80% vs. 67% vs. 70% vs. 65%, P = 0.001), tumor location further from the optic disc (P < 0.001) and foveola (P < 0.001), and greater median tumor basal diameter (10.0 vs. 13.0 vs. 14.0 vs. 16.0 mm, P < 0.001) and tumor thickness (3.5 vs. 5.2 vs. 6.0 vs. 7.1 mm, P < 0.001). The Kaplan-Meier (5-year/10-year) rate of metastasis was 4%/6% for Group A, 12%/20% for Group B, 33%/49% for Group C, and 60%/not available for Group D.

Conclusion:

A simplified 4-category classification of uveal melanoma using TCGA, based on tumor DNA, is highly predictive of risk for metastatic disease.

• Authors: Carol L Shields, Eileen L Mayro, Zeynep Bas, Philip W Dockery, Antonio Yaghy, Sara E Lally, Arupa Ganguly, Jerry A Shields
• Journal: Indian journal of ophthalmology (Indian J Ophthalmol) Vol. 69 Issue 7 Pg. 1839-1845 (07 2021) ISSN: 1998-3689 [Electronic] India
• PMID: 34146040 (Publication Type: Journal Article)

Topics

• Aged
• Humans
• Melanoma (diagnosis, genetics)
• Prognosis
• Retrospective Studies
• Uveal Neoplasms (diagnosis, epidemiology, genetics)