Jochems Anouk, van der Kooij Monique K, Fiocco Marta, Schouwenburg Maartje G, Aarts Maureen J, van Akkooi Alexander C, van den Berkmortel Franchette W P J, Blank Christian U, van den Eertwegh Alfonsus J M, Franken Margreet G, de Groot JanWillem B, Haanen John B A G, Hospers Geke A P, Koornstra Rutger H, Kruit Wim H J, Louwman Marieke, Piersma Djura, van Rijn Rozemarijn S, Suijkerbuijk Karijn P M, Ten Tije Albert J, Vreugdenhil Gerard, Wouters Michel W J M, van Zeijl Michiel C T, van der Hoeven Koos J M, Kapiteijn Ellen
Department of Medical Oncology, Leiden University Medical Centre, Albinusdreef 2, po box 9600, 2300 RC Leiden, The Netherlands.
Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, 2333 AA Leiden, The Netherlands.
Cancers (Basel). 2019 Jul 18;11(7):1007. doi: 10.3390/cancers11071007.
Uveal melanoma (UM) is the most common primary intraocular tumor in adults. Up to 50% of UM patients will develop metastases. We present data of 175 metastatic UM patients diagnosed in the Netherlands between July 2012 and March 2018. In our cohort, elevated lactate dehydrogenase level (LDH) is an important factor associated with poorer survival (Hazard Ratio (HR) 9.0, 95% Confidence Interval (CI) 5.63-14.35), and the presence of liver metastases is negatively associated with survival (HR 2.09, 95%CI 1.07-4.08). We used data from the nation-wide Dutch Melanoma Treatment Registry (DMTR) providing a complete overview of the location of metastases at time of stage IV disease. In 154 (88%) patients, the liver was affected, and only 3 patients were reported to have brain metastases. In 63 (36%) patients, mutation analysis was performed, showing a GNA11 mutation in 28.6% and a GNAQ mutation in 49.2% of the analyzed patients. In the absence of standard care of treatment options, metastatic UM patients are often directed to clinical trials. Patients participating in clinical trials are often subject to selection and usually do not represent the entire metastatic UM population. By using our nation-wide cohort, we are able to describe real-life treatment choices made in metastatic UM patients and 1-year survival rates in selected groups of patients.
葡萄膜黑色素瘤（UM）是成人中最常见的原发性眼内肿瘤。高达50%的UM患者会发生转移。我们呈现了2012年7月至2018年3月期间在荷兰诊断出的175例转移性UM患者的数据。在我们的队列中，乳酸脱氢酶水平（LDH）升高是与较差生存率相关的重要因素（风险比（HR）9.0，95%置信区间（CI）5.63 - 14.35），并且肝转移的存在与生存率呈负相关（HR 2.09，95%CI 1.07 - 4.08）。我们使用了来自荷兰全国黑色素瘤治疗登记处（DMTR）的数据，该数据提供了IV期疾病时转移部位的完整概述。在154例（88%）患者中，肝脏受到影响，只有3例患者报告有脑转移。在63例（36%）患者中进行了突变分析，结果显示在分析的患者中，28.6%有GNA11突变，49.2%有GNAQ突变。在缺乏标准治疗方案的情况下，转移性UM患者常被引导参加临床试验。参加临床试验的患者往往经过筛选，通常不能代表整个转移性UM人群。通过使用我们的全国性队列，我们能够描述转移性UM患者实际做出的治疗选择以及特定患者群体的1年生存率。
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