Sensitivity and Specificity of Different Prognostic Systems in Guiding Surveillance for Metastases in Uveal Melanoma

Helena Robinson, Antonio Eleuteri, Joseph J. Sacco, Rumana Hussain, Heinrich Heimann, Azzam F. G. Taktak, Bertil Damato, Alexander J. Thompson, Thomas Allen, Helen Kalirai, Sarah E. Coupland

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Abstract

Uveal melanoma (UM) metastasises in ~50% of patients, most frequently to the liver. Surveillance imaging can provide early detection of hepatic metastases; however, guidance regarding UM patient risk stratification for surveillance is unclear. This study compared sensitivity and specificity of four current prognostic systems, when used for risk stratification for surveillance, on patients treated at the Liverpool Ocular Oncology Centre (LOOC) between 2007–2016 (n = 1047). It found that the Liverpool Uveal Melanoma Prognosticator Online III (LUMPOIII) or Liverpool Parsimonious Model (LPM) offered greater specificity at equal levels of sensitivity than the American Joint Committee on Cancer (AJCC) system or monosomy 3 alone, and suggests guidance to achieve 95% sensitivity and 51% specificity (i.e., how to detect the same number of patients with metastases, while reducing the number of negative scans). For example, 180 scans could be safely avoided over 5 years in 200 patients using the most specific approach. LUMPOIII also offered high sensitivity and improved specificity over the AJCC in the absence of genetic information, making the result relevant to centres that do not perform genetic testing, or where such testing is inappropriate or fails. This study provides valuable information for clinical guidelines for risk stratification for surveillance in UM.

OriginalsprogEngelsk
Artikelnummer2610
TidsskriftCancers
Vol/bind15
Udgave nummer9
ISSN2072-6694
DOI
StatusUdgivet - 4. maj 2023
Udgivet eksterntJa

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