Treatment of metastatic uveal melanoma in Finland
BackgroundNo consensus exists regarding the treatment of metastatic uveal melanoma. We report the overall survival (OS) of Finnish patients by treatment and by university hospital district on the basis of a nation-wide dataset.
MethodsThis nation-wide study included 338 patients who were treated for primary uveal melanoma in Helsinki University Hospital and who were diagnosed with metastases between 1999 and 2016. The patients were categorized by the Helsinki University Hospital Working Formulation, the first-line treatment and the university hospital district.
ResultsOf all patients, 33% were managed with best supportive care and 67% received active treatment, the corresponding rates by university hospital district being 21–40% and 60–79%, respectively. Median overall survival was 1.6 months for best supportive care, 12 months for active treatment, and 9.0 months for the whole cohort. Of the actively treated patients, 9% received surgical resection. Of all patients, 5% participated in trials. In stage IVa (predicted OS ≥ 12 months), median OS for actively treated patients was 18 months and for those who received best supportive care 12 months. OS was comparable regardless of university hospital district for stages IVa and IVb (predicted OS 6–12 months), (p = 0.90 and p = 0.91). For stage IVc, the difference disappeared on closer analysis (p = 0.33).
ConclusionsOverall survival rates between the university hospital districts were comparable, and also internationally. Considering the new emerging treatment modalities, biopsy of metastases is recommended.
Elina S. Rantala, Meri-Sisko Vuoristo, Micaela Hernberg, Tero T. Kivelä
Elina S. Rantala
University of Helsinki and Helsinki University Hospital, Department of Ophthalmology