Surgical treatment of liver metastases of uveal melanoma (LMUM) could be proposed for selected patients. This retrospective study examined the prognostic significance of the genetic profiles of liver metastases after LMUM resection. A total of 86 patients treated with resection for LMUM, who underwent genetic analysis of liver metastasis, were included. A multivariable Cox model identified the independent predictors of recurrence-free survival (RFS) and overall survival (OS). The disease-free interval (DFI) and a chromosome 8q surgain (>3 copies) were independent predictors and categorized patients into three risk groups with distinct postoperative prognoses. For the low-, intermediate-, and high-risk scores of recurrence, the median RFS values were 15 months (95% CI: 10–22), 6 months (95% CI: 4–11), and 4 months (95% CI: 2–7), and the median OS values were 86 months (95% CI: 55-NR), 25 months (95% CI: 17–48), and 19 months (95% CI: 12–22), respectively. The predictive accuracy of this scoring system was demonstrated by a mean area under the curve (AUC(t)) of 0.77 (95% CI: 0.65–0.90) for RFS and 0.81 (95% CI: 0.70–0.92) for OS. This novel score, based on a DFI of ≤24 months combined with a chromosome 8q surgain, identifies patients at a high risk of early recurrence and could help clinicians to propose perioperative treatment.
对于经过筛选的患者，可考虑采用手术治疗葡萄膜黑色素瘤肝转移。本回顾性研究探讨了LMUM切除术后肝转移灶基因谱的预后意义。研究共纳入86例接受LMUM切除术并完成肝转移灶基因分析的患者。通过多变量Cox模型确定了无复发生存期和总生存期的独立预测因子。无病间期和8号染色体长臂扩增（拷贝数>3）被确认为独立预测因子，并据此将患者划分为具有不同术后预后的三个风险组。在低危、中危和高危复发评分组中，中位RFS分别为15个月（95% CI：10-22）、6个月（95% CI：4-11）和4个月（95% CI：2-7）；中位OS分别为86个月（95% CI：55-未达到）、25个月（95% CI：17-48）和19个月（95% CI：12-22）。该评分系统的预测准确性通过曲线下面积均值得到验证：RFS的AUC(t)为0.77（95% CI：0.65-0.90），OS为0.81（95% CI：0.70-0.92）。这一基于≤24个月无病间期结合8号染色体长臂扩增的新型评分系统，能够识别早期复发高风险患者，有助于临床医生制定围手术期治疗方案。
肿瘤(癌症)患者之家