Development of a Prognostic Nomogram for Liver Metastasis of Uveal Melanoma Patients Selected by Liver MRI.
Pascale MarianiSylvain DureauAlexia SavignoniLivia Lumbroso-Le RouicChristine Levy-GabrielSophie Piperno-NeumannManuel J RodriguesLaurence DesjardinsNathalie CassouxVincent ServoisPublished in: Cancers (2019)
Patients with liver metastases of uveal melanoma (LMUM) die from their metastatic evolution within 2 years. We established a nomogram to choose a treatment adapted to life expectancy. From 2002 to 2013, we reviewed 224 patients with LMUM selected by liver MRI. A nomogram was developed based on a Cox model. The predictive performance of the model was assessed according to the C-statistic, Kaplan-Meier curve, and calibration plots. The median follow-up was 49.2 months (range, 0.6-70.9). The survival rates at 6, 12, and 24 months were 0.88 (0.95 CI [0.84-0.93]), 0.68 (0.95 CI [0.62-0.75]), and 0.26 (0.95 CI [0.21-0.33]), respectively. The four factors selected for the nomogram with a worse prognosis were: A disease-free interval between the UM and LMUM groups of less than 6 months (HR = 3.39; 0.95 CI [1.90-6.05]), more than 10 LMUM (HR = 3.95; 0.95 CI [1.97-4.43]), a maximum LMUM of more than 1200 mm2 (HR = 2.47; 0.95 CI [1.53-3.98]), and a lactate dehydrogenase (LDH) value greater than 1.5 (HR = 3.72; 0.95 CI [2.30-6.00]). The model achieved relatively good discrimination and calibration (C-statistic 0.71). This nomogram could be useful for decision-making and risk stratification for therapeutic options.
Keyphrases
- lymph node metastasis
- end stage renal disease
- magnetic resonance imaging
- liver metastases
- squamous cell carcinoma
- decision making
- contrast enhanced
- small cell lung cancer
- newly diagnosed
- chronic kidney disease
- computed tomography
- peritoneal dialysis
- diffusion weighted imaging
- prognostic factors
- magnetic resonance
- smoking cessation