Parsimonious Models for Predicting Mortality from Choroidal Melanoma.



Damato, Bertil, Eleuteri, Antonio, Hussain, Rumana ORCID: 0000-0001-8208-5009, Kalirai, Helen ORCID: 0000-0002-4440-2576, Thornton, Sophie, Taktak, Azzam, Heimann, Heinrich and Coupland, Sarah E ORCID: 0000-0002-1464-2069
(2020) Parsimonious Models for Predicting Mortality from Choroidal Melanoma. Investigative ophthalmology & visual science, 61 (4). 35 - 35.

[img] Text
damato_iovs_manuscript_revised.docx - Accepted Version

Download (446kB)

Abstract

Purpose:To develop parsimonious models for estimating metastasis mortality in patients with choroidal melanoma for situations where use of the Liverpool Uveal Melanoma Prognosticator Online (LUMPO) or Tumor, Node, Metastasis (TNM) staging system is not possible. Methods:A backward-selection algorithm identified largest basal tumor diameter (LBTD) and chromosome 3 status (C3S) as the most informative predictors of metastatic death. We defined two prognostic models, based on LBTD with or without known C3S, that took into account competing risks of death from other causes by using the Aalen estimator. The bootstrap procedure was used to estimate discrimination accuracy, expressed by the C-index. Results:The cohort was comprised of 8348 patients with choroidal melanoma, 4174 of whom had known chromosome 3 status; of the 1553 deaths that occurred among these patients, 956 were attributed to metastasis. For LBTD with or without known C3S, the metastatic-death-specific C-indices at 2, 5, and 10 years were 0.85, 0.85, and 0.84 and 0.79, 0.77, and 0.74, respectively, as compared with 0.81, 0.79, and 0.76 for Kaplan-Meier prognostication using the 8th edition of the TNM staging system. Conclusions:We have developed parsimonious models for predicting the absolute risks of metastatic death from choroidal melanoma that take into account competing causes of death and which compare favorably with the current version of the TNM staging system. There is a need for further studies to validate the use of these models in situations where use of the TNM or LUMPO is not possible.

Item Type: Article
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Clinical Directorate
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Faculty of Science and Engineering > School of Physical Sciences
Depositing User: Symplectic Admin
Date Deposited: 11 May 2020 10:28
Last Modified: 02 Oct 2021 07:12
DOI: 10.1167/iovs.61.4.35
Open Access URL: https://doi.org/10.1167/iovs.61.4.35
URI: https://livrepository.liverpool.ac.uk/id/eprint/3086513