External Validation of the Liverpool Uveal Melanoma Prognosticator Online.
OBJECTIVE
To validate the Liverpool Uveal Melanoma Prognosticator Online (LUMPO) in a cohort of patients treated at the University of California-San Francisco (UCSF).


METHODS
A retrospective chart review was performed of 390 patients treated between 2002 and 2007 for choroidal melanoma at UCSF. Similar patients (n = 1175) treated at the Liverpool Ocular Oncology Centre (LOOC) were included in the study. The data were analyzed using the model previously developed for LUMPO, an online prognostication tool combining multiple prognostic factors. Main outcome measures included all-cause mortality and melanoma-specific mortality. Reliability of the survival estimates in each group of patients was indicated by the C-indices of discrimination and Hosmer-Lemeshow test.


RESULTS
Patients treated at UCSF tended to be younger with thicker tumors, and were more likely to receive proton beam radiotherapy as primary treatment compared to patients at LOOC. There were no significance differences with respect to ciliary body involvement, melanoma cytomorphology, and mitotic counts between the two groups. Death occurred in 140/390 (35%) patients from UCSF and 409/1175 (34%) patients from LOOC, with no difference in overall mortality by Kaplan-Meier analysis (log rank test, P = 0.503). For all-cause mortality and melanoma-specific mortality, the C-index of discrimination and Hosmer-Lemeshow test at 5 years after treatment indicated good discrimination performance of the model, with no statistically significant difference between observed and predicted survival.


CONCLUSIONS
Despite differences between the two cohorts, external validation in patients treated at UCSF indicates that LUMPO estimated the all-cause and melanoma-specific mortality well.
Department of Ophthalmology, University of California-San Francisco, San Francisco, California, United States.
Sarah W
SW
DeParis
Department of Medical Physics and Clinical Engineering, Royal Liverpool University Hospital, Liverpool, United Kingdom.
Azzam
A
Taktak
Department of Medical Physics and Clinical Engineering, Royal Liverpool University Hospital, Liverpool, United Kingdom.
Antonio
A
Eleuteri
Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, United States.
Wayne
W
Enanoria
Liverpool Ocular Oncology Service, Royal Liverpool University Hospital, Liverpool, United Kingdom.
Heinrich
H
Heimann
Pathology, Department of Molecular and Clinical Cancer Medicine, University of Liverpool, Liverpool, United Kingdom.
Sarah E
SE
Coupland
Department of Ophthalmology, University of California-San Francisco, San Francisco, California, United States 4Liverpool Ocular Oncology Service, Royal Liverpool University Hospital, Liverpool, United Kingdom.
Bertil
B
Damato
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death / Q000639:trends; D018450:Disease Progression; D005260:Female; D005544:Forecasting; D006801:Humans; D020407:Internet; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000401:mortality*; D008875:Middle Aged; D009367:Neoplasm Staging; D015203:Reproducibility of Results; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D014481:United States; D014604:Uveal Neoplasms / Q000175:diagnosis / Q000401:mortality*; D055815:Young Adult; D000098943:Uveal Melanoma