title: Independent Prognostic Significance of Gene Expression Profile Class and Largest Basal Diameter of Posterior Uveal Melanomas.
abstract: OBJECTIVE
  To determine whether any conventional clinical prognostic factors for metastasis from uveal melanoma retain prognostic significance in multivariate models incorporating gene expression profile (GEP) class of the tumor cells.
  
  
  METHODS
  Prospective, interventional case series with a prognostic model.
  
  
  METHODS
  Single-institution study of GEP testing and other conventional prognostic factors for metastasis and metastatic death in 299 patients with posterior uveal melanoma evaluated by fine-needle aspiration biopsy (FNAB) at the time of or shortly prior to initial treatment. Univariate prognostic significance of all evaluated potential prognostic variables (patient age, largest linear basal diameter of tumor [LBD], tumor thickness, intraocular location of tumor, melanoma cytomorphologic subtype, and GEP class) was performed by comparison of Kaplan-Meier event rate curves and univariate Cox proportional hazards modeling. Multivariate prognostic significance of combinations of significant prognostic factors identified by univariate analysis was performed using step-up and step-down Cox proportional hazards modeling.
  
  
  RESULTS
  GEP class was the strongest prognostic factor for metastatic death in this series. However, tumor LBD, tumor thickness, and intraocular tumor location also proved to be significant individual prognostic factors in this study. On multivariate analysis, a 2-term model that incorporated GEP class and largest basal diameter was associated with strong independent significance of each of the factors.
  
  
  CONCLUSIONS
  Although GEP test is the most robust prognostic indicator in uveal melanoma and early studies of mostly larger tumors found that no clinicopathologic factors had significant prognostic value independent of GEP, our single-center study, which included a substantial proportion of smaller tumors, showed that both GEP and LBD of the tumor are independent prognostic factors for metastasis and metastatic death in multivariate analysis.
authors.affiliation: Department of Ophthalmology and the Ophthalmic Pathology Laboratory, College of Medicine, University of Cincinnati; and Ocular Oncology & Diagnostic Ocular Ultrasonography Service, University of Cincinnati Academic Health Center, Cincinnati, Ohio. Electronic address: correazm@uc.edu.
authors.forename: Zélia M
authors.initials: ZM
authors.lastname: Corrêa
authors.affiliation: Department of Ophthalmology and the Ophthalmic Pathology Laboratory, College of Medicine, University of Cincinnati; and Ocular Oncology & Diagnostic Ocular Ultrasonography Service, University of Cincinnati Academic Health Center, Cincinnati, Ohio.
authors.forename: James J
authors.initials: JJ
authors.lastname: Augsburger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005260:Female; D020869:Gene Expression Profiling / Q000145:classification; D052138:Genes, Neoplasm; D006801:Humans; D008297:Male; D008545:Melanoma / Q000145:classification / Q000175:diagnosis* / Q000235:genetics* / Q000401:mortality; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000235:genetics; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015996:Survival Rate; D059467:Transcriptome / Q000235:genetics*; D014604:Uveal Neoplasms / Q000145:classification / Q000175:diagnosis* / Q000235:genetics* / Q000401:mortality; D000098943:Uveal Melanoma
chemical_list: D009363:Neoplasm Proteins