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The Results of Stricter Inclusion Criteria in an Immunomagnetic Detection Study of Micrometastatic Cells in Bone Marrow of Uveal Melanoma Patients - Relevance for Dormancy

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Pathology & Oncology Research

Abstract

Approximately 50% of uveal melanoma patients develop metastases. We want to evaluate the effect of stricter criteria on our data from our previous study correlating survival and bone marrow (BM) micrometastasis results using our immunomagnetic separation (IMS) method. Mononuclear cell fractions (MNC) isolated from BM were examined for tumour cells and the patients were classified as BM positive (BM+) or BM negative (BM-). The study originally included 328 consecutive patients with uveal melanoma from 1997 to 2006. The cohort was limited to 217 patients when we introduced cyto- or histopathological verification of melanoma cells in the patient as a main new criterion for inclusion. Tumour cells were found in BM-samples in 38.7% (95% CI, 32–45) at enrolment. Until the latest work-up 43.8% (95% CI, 38–50) of patients had developed melanoma metastases. After a minimum follow-up time of 8.5 years, 60.4% (95% CI, 54–66) of patients had died. The causes were: melanoma metastases 69.5%, another type of cancer 5.4% and non-cancerous causes 19.5%. Overall median survival was shorter for the BM- patients (11.3 years) (95% CI, 10–12) compared to the BM+ (16.5 years) (95% CI, 12–14), p = 0.04, log rank test. All-cause mortality and specific melanoma mortality estimated after 12 year follow-up showed a highly significant difference comparing BM- and BM+, p = 0.010 and p = 0,017, respectively. IMS yields a high fraction of BM+ samples due to micrometastasis at diagnosis and these cells appear to have a positive prognostic impact strengthening our previous report. The late recurrences support the concept of tumour dormancy.

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Authors and Affiliations

  1. Department of Ophthalmology, Oslo University Hospital HF, Post box 4950, Nydalen, 0424, Oslo, Norway

    Nils Eide, Geir A. Qvale & Rowan Faber

  2. Department of Dermatology, Oslo University Hospital HF, Oslo, Norway

    Ragnar S. Faye

  3. Department of Tumor Biology, Oslo University Hospital HF and University of Oslo, Oslo, Norway

    Ragnar S. Faye, Hanne K. Høifødt & Øystein Fodstad

  4. Department of Statistics, Oslo University Hospital HF, Oslo, Norway

    Leiv Sandvik

  5. Division of Pathology, Oslo University Hospital HF, Oslo, Norway

    Peter Jebsen

  6. Department of Oncology, Oslo University Hospital HF, Oslo, Norway

    Gunnar Kvalheim

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  1. Nils Eide
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Eide, N., Faye, R.S., Høifødt, H.K. et al. The Results of Stricter Inclusion Criteria in an Immunomagnetic Detection Study of Micrometastatic Cells in Bone Marrow of Uveal Melanoma Patients - Relevance for Dormancy. Pathol. Oncol. Res. 25, 255–262 (2019). https://doi.org/10.1007/s12253-017-0355-7

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