Conditional Survival in Uveal Melanoma.

PURPOSE To investigate conditional survival in patients with uveal melanoma in the United States DESIGN: Cohort study SUBJECTS: Patients were identified using International Classification of Disease for Oncology (ICD-O-3) codes for both morphology (melanoma: 8720--8790) and site (retina: C69.2, choroid: C69.3, and ciliary body: C69.4) from 1975 to 2011 using the Surveillance, Epidemiology, and End Results (SEER) database SEER 18. METHODS Observed metastasis free survival (MFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Conditional metastasis free survival (cMFS) and conditional overall survival (cOS) were calculated based on the observed MFS and OS. Relative survival was also calculated using the actuarial method. Survival to 5 and 10 years after diagnosis were calculated, conditioned on various numbers of years already survived. MAIN OUTCOME MEASURES Conditional metastasis free survival, conditional overall survival, and conditional relative survival RESULTS: A total of 6863 cases of uveal melanoma were identified. Median follow-up among survivors was 11 years. During follow-up 3883 patients died from any cause, and of these 2131 were deaths due to metastatic uveal melanoma. The non-conditional 5 year MFS was 80%. After surviving 1, 2, 3, or 4 years after diagnosis, the 5 year cMFS estimates increased to 82%, 87%, 92%, and 96%, respectively. The non-conditional MFS at 10 years was estimated to be 69%. After having survived 5, 6, 7, 8, or 9 years after diagnosis, the 10 year cMFS estimates increased to 87%, 90%, 93%, 96%, and 98%, respectively. This result pattern was confirmed with estimates of relative survival. CONCLUSION Conditional survival estimates of uveal melanoma improve with time since primary diagnosis. Amongst patients who have already survived for at least 5 years, 10 year conditional survival rates are high. Conditional survival analysis can provide specific guidance for counselling patients.