High C-Reactive Protein Levels Are Related to Better Survival in Patients with Uveal Melanoma.

PURPOSE

To determine whether peripheral blood leukocyte numbers and serum markers of inflammation can be used to predict which patients with primary uveal melanoma will develop metastasis.

DESIGN

Retrospective study.

PARTICIPANTS

Medical records of patients with uveal melanoma (UM) who received treatment for primary UM between February 1992 and December 2020 at the Erasmus University Medical Center (Rotterdam, The Netherlands) and the Rotterdam Eye Hospital (Rotterdam, The Netherlands) were reviewed.

METHODS

Inclusion criteria were the presence of a melanoma of the choroid or ciliary body and the availability of data from peripheral blood samples taken before treatment of the melanoma. Data including patient demographics, C-reactive protein (CRP) levels; erythrocyte sedimentation rate (ESR); number of leukocytes, neutrophils, monocytes, and lymphocytes; and histopathologic findings were obtained from medical records. Neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were calculated.

MAIN OUTCOME MEASURES

Metastasis-free survival.

RESULTS

Of the 807 patients with UM, serum and leukocyte data were available for 183 of them at the time of primary tumor treatment. In the total group, no correlation was found between ESR before treatment; the number of leukocytes; percentages of neutrophils, monocytes, and lymphocytes; or NLR or LMR values and any of the clinical characteristics or metastasis-free survival. Among patients who underwent enucleation, those with negative findings showed significantly lower numbers of leukocytes ( < 0.05). In the entire cohort, a significant association was found between high CRP levels and longer metastasis-free survival (MFS;  = 0.049).

CONCLUSIONS

The total blood leukocyte number was related to loss of staining in patients who underwent enucleation, with lower leukocyte counts correlating with absent staining. Higher CRP levels were associated with a longer MFS in the entire cohort. Neither the NLR nor the LMR is a good predictor for metastasis developing in patients with UM.