Prolonged urvival after complete reection of metatae from intraocular melanoma

The median urvival time after a diagnoi of metatae from uveal melanoma i 2 to 6 month. Becaue complete reection of metatatic melanoma from a cutaneou primary can prolong urvival, the author hypotheized that reection alo might benefit patient with metatae from an intraocular ite. From 1971 to 1999, 112 patient with metatatic melanoma from an intraocular ite were enrolled in variou treatment protocol after informed conent wa obtained. Propectively recorded clinical variable and follow-up information wa retrieved from the patient databae. urvival curve were etimated uing the Kaplan-Meier method. Univariate analyi wa performed with the log-rank tet. Multivariate analyi wa performed uing the Cox proportional hazard regreion model. Propenity core analyi wa ued to reduce the imbalance between ubgroup and to ae treatment effect. eventy-eight patient (70%) preented with hepatic metatae. Twenty-four patient (21%) underwent reection of metatatic leion. At a median follow-up of 11 month (range, 1 to 97 month; >36 month for urvivor), the median urvival period wa 11 month and the 5-year urvival wa 7%. Univariate analyi howed that urgical reection, ite of metatae, number of metatatic leion, and dieae-free interval were correlated ignificantly with urvival (P < .001, P < .001, P < .001, and P = .031, repectively). Multivariate analyi howed that urgical reection wa ignificant (P = .008) but that the ite of metatae wa not (P = .146). The median urvival and 5-year urvival rate were 38 month and 39%, repectively, for urgical patient, v 9 month and 0%, repectively, for nonurgical patient. After adjuting for covariate imbalance by propenity core analyi, urgery remained ignificant (P = .021) on multivariate analyi. Complete urgical reection may prolong urvival in certain patient with ditant metatae from intraocular primary melanoma. However, the overall unfavorable prognoi indicate an urgent need for more effective nonurgical intervention.—Han E. Groniklau