Lorenzo, DanielOchoa, MaríaPiulats, Josep MariaGutiérrez, CristinaArias, LuisCatalà, JaumeGrau Magaña, MariaPeñafiel Muñoz, JudithCobos, EstefaníaGarcia-Bru, PereRubio, Marcos JavierPadrón-Pérez, NoelDias, BrunoPera, JoanCaminal, Josep Maria2018-10-222018-10-222017Lorenzo D, Ochoa M, Piulats JM, Gutiérrez C, Arias L, Català J. et al. Prognostic Factors and Decision Tree for Long-term Survival in Metastatic Uveal Melanoma. Cancer Res Treat. 2018; 50(4): 1130-1139. DOI: 10.4143/crt.2017.1711598-2998http://hdl.handle.net/10230/35626PURPOSE: The purpose of this study was to demonstrate the existence of a bimodal survival pattern in metastatic uveal melanoma. Secondary aims were to identify the characteristics and prognostic factors associated with long-term survival and to develop a clinical decision tree. MATERIALS AND METHODS: The medical records of 99 metastatic uveal melanoma patients were retrospectively reviewed. Patients were classified as either short (≤ 12 months) or long-term survivors (> 12 months) based on a graphical interpretation of the survival curve after diagnosis of the first metastatic lesion. Ophthalmic and oncological characteristicswere assessed in both groups. RESULTS: Of the 99 patients, 62 (62.6%) were classified as short-term survivors, and 37 (37.4%) as long-term survivors. The multivariate analysis identified the following predictors of long-term survival: age ≤ 65 years (p=0.012) and unaltered serum lactate dehydrogenase levels (p=0.018); additionally, the size (smaller vs. larger) of the largest liver metastasis showed a trend towards significance (p=0.063). Based on the variables significantly associated with long-term survival, we developed a decision tree to facilitate clinical decision-making. CONCLUSION: The findings of this study demonstrate the existence of a bimodal survival pattern in patients with metastatic uveal melanoma. The presence of certain clinical characteristics at diagnosis of distant disease is associated with long-term survival. A decision tree was developed to facilitate clinical decision-making and to counsel patients about the expected course of diseaseapplication/pdfengCopyright ⓒ 2018 by the Korean Cancer Association. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly citedTumorsMelanomainfo:eu-repo/semantics/articlehttp://dx.doi.org/10.4143/crt.2017.171Decision treesLong-term survivorsNeoplasm metastasisUveal melanomainfo:eu-repo/semantics/openAccess