Development of a Prognostic Nomogram for Liver Metastasis of Uveal Melanoma Patients Selected by Liver MRI

Abstract

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.

Keywords

• uveal melanoma
• liver metastasis
• prognostic factors
• liver MRI
• tumour burden