Distant Metastases in Patients with Primary Uveal Melanoma

The distant metastases in uveal melanoma are not thoroughly investigated. Records of 3369 patients with primary uveal melanoma from 2010 to 2016 in the Surveillance, Epidemiology, and End Result (SEER) database were analyzed for the incidence of distant metastases and overall survival of patients with metastases were calculated. Risk factors for metastasis occurrence and prognostic factors for survival were investigated by logistic regression analysis and Cox hazard regression. Sixty-three patients (1.87%) presented distant metastases, including 49, 17, 16, and 6 patients with metastasis to liver, brain, lung, and bone, respectively. Higher T stage (T3 OR = 3.34, 95% CI: 1.16–9.57; T4 OR = 12.44, 95% CI: 4.63–33.46) and N1 stage (OR = 105.57, 95% CI: 13.40–832.13) were risk factors for distant metastases. The median overall survival for patients with distant metastases was 9.0 (95% CI: 6.37–11.63) months with a 2-year survival rate of 25.2%. Age >60 years (HR = 2.91, 95% CI: 1.49–5.68) and tumor at ciliary body (HR = 2.33, 95% CI: 1.11–4.87) were associated with worse survival. The survival was significantly dismal in patients with primary uveal melanoma and distant metastases, especially those with hepatic metastasis. T3-4 stage was risk factor for the development of distant metastases while patients with age >60 years or tumor at the ciliary body were significantly associated with worse survival.