Introduction: Prognosis of uveal melanoma (UM) is assessed using clinical staging or molecular testing. Two modalities often used for prognostication are the American Joint Committee on Cancer (AJCC) staging and a tumor gene expression profile (GEP), the outcomes of which are often discordant. This paper discusses a Total Risk Score created to combine the discordant information from both sources. Methods: A retrospective case series was conducted of all patients presenting with UM over six years to two referral centers. Each tumor was classified using the AJCC and the GEP. A Total Risk Score was calculated for each patient using results from both AJCC and GEP. Kaplan-Meier analysis of metastasis free-survival was used to compare groups. Results: A total of 294 patients were included in the study. Kaplan-Meier estimates showed significant curve separation between individual AJCC and GEP risk groups. The combined Total Risk Score provided an accurate estimate of prognosis that incorporated results from both AJCC and GEP. Conclusions: Clinical staging and molecular prognostication of UM can be discordant. There is important information provided by each system that is not provided by the other. The Total Risk Score provides a simple method to combine information from both the AJCC stage and the GEP class in order to provide patients and care teams with a more complete understanding of metastatic risk.


中文翻译：

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通过临床分期和分子预后的综合评分提高葡萄膜黑色素瘤的预后精度

简介：葡萄膜黑色素瘤 (UM) 的预后使用临床分期或分子检测进行评估。通常用于预测的两种方式是美国癌症联合委员会 (AJCC) 分期和肿瘤基因表达谱 (GEP)，其结果通常不一致。本文讨论了为结合来自两个来源的不一致信息而创建的总风险评分。方法：对所有在 6 年内到两个转诊中心就诊的 UM 患者进行回顾性病例系列研究。使用 AJCC 和 GEP 对每个肿瘤进行分类。使用 AJCC 和 GEP 的结果计算每位患者的总风险评分。Kaplan-Meier 无转移生存分析用于组间比较。结果：共有 294 名患者被纳入研究。Kaplan-Meier 估计显示个体 AJCC 和 GEP 风险组之间存在显着的曲线分离。合并的总风险评分提供了对预后的准确估计，其中包含了 AJCC 和 GEP 的结果。结论：UM的临床分期和分子预后可能不一致。每个系统都提供了其他系统未提供的重要信息。总风险评分提供了一种简单的方法来结合来自 AJCC 阶段和 GEP 类别的信息，以便让患者和护理团队更全面地了解转移风险。UM 的临床分期和分子预后可能不一致。每个系统都提供了其他系统未提供的重要信息。总风险评分提供了一种简单的方法来结合来自 AJCC 阶段和 GEP 类别的信息，以便让患者和护理团队更全面地了解转移风险。UM 的临床分期和分子预后可能不一致。每个系统都提供了其他系统未提供的重要信息。总风险评分提供了一种简单的方法来结合来自 AJCC 阶段和 GEP 类别的信息，以便让患者和护理团队更全面地了解转移风险。