Using the uveal melanoma classification system to predict patient outcomes

The authors aimed to determine patient outcomes using the standard classification systems in uveal melanoma patients.

Uveal melanoma is a rare form of cancer that occurs in the eye. The TNM classification system can be used to determine the extent of melanoma present and can help identify the most effective treatment options available. The TNM classification system is the standard system used to determine what stage the cancer is at.

T determines the size and extent of the tumor, 1 indicating a relatively small tumor and 4 indicating a large tumor.

N determines whether the cancer has spread to the lymph nodes, where 0 indicates no lymph node involvement and 3 indicates extensive lymph node involvement (sites that hold the immune cells).

M determines whether the cancer has spread to other parts of the body, where 0 indicates the cancer has not spread to other body parts and 1 indicates distant cancer spread.

The aim of this study was to determine patient outcomes using the TNM system in patients with uveal melanoma.

3,377 patients were used in this study with an average follow-up time of 3.2 years. 98% of patients were metastasis-free at 1 year, 86% were metastasis-free at 5-years and 81% at 10 years. 

10-year metastasis free rates were 94% for T1 patients, 80% for T2 patients and 68% for T3 patients. The 5-year metastasis-free rate was 61% for T4 patients. An increase in tumor size was significantly associated with an increased risk of experiencing cancer spread.

Based on cancer stages (stages I to III where I indicates cancer is only in one part of the eye and III indicates cancer has spread through and onto the outside of the eye) the 10-year metastasis-free rates were 94% for stage I, 84% for stage IIA, 70% for stage IIB, 60% for stage IIIA, 50% for stage IIIB. For stage IIIC, the 5-year metastasis-free rate was 25% for stage IIIC.

This classification system may help patients predict their risk of metastasis and aid in treatment decisions. 

There was no standard diagnosis or treatment in this study so results may differ based on the approach taken.