Prognostic factors of choroidal melanoma in Slovenia, 1986–2008

		Treatment
	Brachytherapy	Enucleation	Total
All patients	130	161	291
Excluded	3 palliations	-	3
Treated	127	161	288
Gender
Man	58	84	142
Women	69	77	146
Age (median)
Men	58 (29-74)	58 (19-86)
Women	60 (22-89)	61 (23-92)
T-stage (AJCC)
1	38
2	69
3	8
No data	12
Thickness
< 3 mm	11
3.1-5.0 mm	64
5.1-7.2 mm	49
> 7.8 mm	3
No data	0
Basal diameter
≤ 10 mm	52
10,1-12,0 mm	38
> 12 mm	25
No data	12
Histology	161
Spindle cell	33
Epithelioid	38
Mixed	23
No data	37

AJCC = American Joint Committee on Cancer

Overall survival of patients treated by brachytherapy after treatment of recurrence.

Table 2

Univariate analysis of survival: all patients (N = 288)

	n	LRC (%)			DFS (%)			DSS (%)			OS (%)
		5 yrs	10 yrs	p	5 yrs	10 yrs	p	5 yrs	10 yrs	p	5 yrs	10 yrs	p
All	288	90	88	-	65	50	-	76	58		68	46	-
Ruthenium	127	78	75		71	60		92	79		87	68
				0.000			0.014			0.000			0.000
Enucleation	161	100	100		60	42		64	42		54	31
Men	142	85	82		61	51		74	61		66	47
				0.026			0.673			0.647			0.952
Women	146	95	93		69	49		78	55		70	46
< 60 years	150	89	86		74	58		86	68		84	64
				0.648			0.002			0.000			0.000
≥ 60 years	138	90	90		56	40		65	47		52	28

DFS = disease free survival; DSS = disease specific survival; LRC = loco-regional control; n = number of patients; OS = overall survival; yrs = years

Table 3

Univariate analysis of survival: patients treated by brachytherapy (N = 127)

		LRC (%)			DFS (%)			DSS (%)			OS (%)
	n	5 yrs	10 yrs	p	5 yrs	10 yrs	p	5 yrs	10 yrs	p	5 yrs	10 yrs	p
Men	58	66	60		60	49		90	76		87	67
				0.003			0.039			0.703			0.859
Women	69	89	87		81	69		93	81		88	70
< 60 years	68	76	71		76	66		98	89		98	83
				0.305			0.156			0.002			0.000
≥ 60 years	59	80	80		65	51		84	65		75	52
T-stage
1	38	79	79		73	67		97	84		94	71
2	69	79	74	0.451	72	57	0.354	90	75	0.378	86	72	0.508
3	8	60	40		45	45		86	86		0	50
Tumour thickness
2-5.9 mm	97	83	82	0.003	74	66	0.021	92	79	0.489	86	68	0.724
6-.2 mm	29	64	54	0.003	64	39	0.021	96	80	0.489	96	70	0.724
Base
< 11 mm	61	83	83	0.043		80	0.002	96	84	0.024	96	77	0.002
≥ 11 mm	54	70	64	0.043	60	45	0.002	87	72	0.024	78	64	0.002
Dose rate Top (Gy/h)
≥ 108 Gy	53	81	78	0.302	74	66	0.099	95	84	0.280	87	72	0.690
< 108 Gy	52	74	68	0.302	68	46	0.099	89	72	0.280	87	62	0.690
Dose- rate base (Gy/h)
≥ 532	53	82	74	0.708	74	57	0.804	95	81	0.665	87	69	0.862
< 532	52	74	71	0.708	68	55	0.804	89	75	0.665	87	65	0.862
Treatment time
≤ 96 hours	52	87	84	0.015	80	72	0.004	95	84	0.400	89	74	0.565
> 96 hours	53	68	62	0.015	62	40	0.004	89	71	0.400	85	60	0.565

DFS = disease free survival; DSS = disease specific survival; LRC = loco-regional control; n = number of patients; OS = overall survival; yrs = years

Incidence of distant metastases according to the type of treatment.

Percentage of annual post-treatment melanoma specific mortality according to the type of treatment. ^*There was no peak in ruthenium treated patients < 60 years.

Linear regression analysis of melanoma related mortality per age decades, according to the type of treatment. Points represent percent mortality rate for the elapsed decade. No patient less than 40 years who was treated with Ru-106 died of melanoma.

Table 4

Univariate analysis of survival: patients treated by enucleation (N = 161)*

		DFS (%)			DSS (%)			OS (%)
	n	5 yrs	10 yrs	p	5y	10 yrs	p	5 yrs	10 yrs	p
Men	84	62	51	0.154	63	51		53	34	0.775
Women	77	59	33	0.154	65	34	0,275	56	27	0.775
< 60 years	82	73	52	0.001	76	52		74	51	0.000
≥ 60 years	79	49	30	0.001	50	30	0.000	34	10	0.000
Spindle cell	33	74	70		81	72		66	49
epithelioid	38	56	36	0.050	61	33	0.029	55	24	0.026
Mixed cell	23	62	28		67	24		52	15

* None of enucleated patients had local recurrence; DFS = disease free survival; DSS = disease specific survival; n = number of patients; OS = overall survival; yrs = years

Table 5

Multivariate analysis of survival of all patients (N = 288)

			HR	95% CI		P
			HR	lower	upper	P
All patients	LRC	First treatment	40.842	5.565	299.717	0.000
		Gender	2.658	1.245	5.678	0.012
	DFS	First treatment	1.628	1.144	2.316	0.007
		Age < 60 years vs. ≥ 60 years	1.800	1.275	2.540	0.001
	DSS	First treatment	3.937	2.509	6.178	0.000
		Age < 60 years vs. ≥ 60 years	2.534	1.714	3.747	0.000
	OS	First treatment	3.153	2.218	4.480	0.000
		Age < 60 years vs. ≥ 60 years	3.818	2.710	5.377	0.000
		Gender	2.306	1.013	5.251	0.047
Ruthenium	LRC
		Treatment time (≤ 96 h vs. > 96 h)	2.841	1.220	6.623	0.015
		Treatment time (≤ 96 h vs. > 96 h)	2.674	1.276	5.587	0.009
	DFS	Base (< 11 mm vs. ≥ 11 mm)	2.519	1.015	6.250	0.046
		T-stage	2.320	1.002	5.376	0.050
	DSS	Age (< 60 years vs. ≥ 60 years)	4.762	1.709	13.333	0.003
	OS	Base (< 11 mm vs v11 mm)	3.610	1.391	9.434	0.008
		Age (< 60 years vs. ≥ 60 years)	5.650	2.538	12.658	0.000
Nucleation	LRC	-	-	-	-	-
	DFS	Age (< 60 years vs. ≥ 60 years)	2.132	1.149	3.968	0.016
		Histology S VS E VS M	1.467	1.000	2.151	0.050
	DSS	Age (< 60 years vs. ≥ 60 years)	2.326	1.229	4.403	0.009
		Histology S vs. E vs. M	1.555	1.052	2.298	0.027
	OS	Age (< 60 years vs. ≥ 60 years)	3.876	2.222	6.757	0.000
		Histology (S vs. E vs. M)	1.444	1.051	1.983	0.023

CI = confident interval; DFS = disease free survival; DSS = disease specific survival; E = epitheloid; HR = hazard ratio; LRC = loco-regional control; M = mixed cell; n = number of patients; OS = overall survival; S = spindle cell

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DOI: https://doi.org/10.1515/raon-2015-0009 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 104 - 112

Submitted on: Nov 17, 2014

Accepted on: Dec 9, 2014

Published on: Feb 16, 2016

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

therapy,

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© 2016 Boris Jancar, Marjan Budihna, Brigita Drnovsek-Olup, Katrina Novak Andrejcic, Irena Brovet Zupancic, Dusica Pahor, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Volume 50 (2016): Issue 1 (March 2016)

Prognostic factors of choroidal melanoma in Slovenia, 1986–2008

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