PURPOSE: To evaluate trends in liver function tests before detection of liver metastases from uveal melanoma. DESIGN: Retrospective, comparative, observational case control study. SETTING: The Israel uveal melanoma center at the Hadassah University Hospital. PATIENT POPULATION: A total of 307 uveal melanoma patients who were diagnosed with uveal melanoma and followed between the years 1988 and 1998. Of them, 30 metastatic patients who had regular follow-up by liver function tests (LFTs) and liver imaging were included in this study. Eighty nonmetastatic patients were randomly chosen as controls. OBSERVATION PROCEDURE: The medical records of the metastatic and control groups were reviewed documenting LFTs and liver imaging results. MAIN OUTCOME MEASURES: The mean level of each LFT, its sensitivity, specificity, and likelihood ratio at various time periods before the detection of metastases by liver imaging. RESULTS: At the time of diagnosis of liver metastases by imaging, 50% of patients had at least one abnormal LFT (compared with only 5% of the control group). While no change was noted in the mean serum levels of bilirubin, mean lactate dehydrogenase (LDH), alkaline-phosphatase, gamma glutamyl transpeptidase (gamma GTP) aspartate-aminotrasferase, and alanine-aminotrasferase levels seem to rise, even within normal limits, during the 6 months before the detection of metastases. Based on likelihood ratios, alkaline-phosphatase and lactate dehydrogenase were the most predictive tests. Lactate dehydrogenase and aspartate-aminotransferase were already predictive at 80% of the upper normal limit, whereas alkaline-phosphatase and gamma-glutamyltransferase were most predictive at the upper normal limit. CONCLUSIONS: Monitoring the changes in selected LFTs, even within normal limits, can help predict metastatic uveal melanoma.
PURPOSE: To evaluate trends in liver function tests before detection of liver metastases from uveal melanoma. DESIGN: Retrospective, comparative, observational case control study. SETTING: The Israel uveal melanoma center at the Hadassah University Hospital. PATIENT POPULATION: A total of 307 uveal melanomapatients who were diagnosed with uveal melanoma and followed between the years 1988 and 1998. Of them, 30 metastatic patients who had regular follow-up by liver function tests (LFTs) and liver imaging were included in this study. Eighty nonmetastatic patients were randomly chosen as controls. OBSERVATION PROCEDURE: The medical records of the metastatic and control groups were reviewed documenting LFTs and liver imaging results. MAIN OUTCOME MEASURES: The mean level of each LFT, its sensitivity, specificity, and likelihood ratio at various time periods before the detection of metastases by liver imaging. RESULTS: At the time of diagnosis of liver metastases by imaging, 50% of patients had at least one abnormal LFT (compared with only 5% of the control group). While no change was noted in the mean serum levels of bilirubin, mean lactate dehydrogenase (LDH), alkaline-phosphatase, gamma glutamyl transpeptidase (gamma GTP) aspartate-aminotrasferase, and alanine-aminotrasferase levels seem to rise, even within normal limits, during the 6 months before the detection of metastases. Based on likelihood ratios, alkaline-phosphatase and lactate dehydrogenase were the most predictive tests. Lactate dehydrogenase and aspartate-aminotransferase were already predictive at 80% of the upper normal limit, whereas alkaline-phosphatase and gamma-glutamyltransferase were most predictive at the upper normal limit. CONCLUSIONS: Monitoring the changes in selected LFTs, even within normal limits, can help predict metastatic uveal melanoma.
Authors: Daniela Suesskind; Andreas Schatz; Sven Schnichels; Sarah E Coupland; Sarah L Lake; Bernd Wissinger; Karl U Bartz-Schmidt; Sigrid Henke-Fahle Journal: Graefes Arch Clin Exp Ophthalmol Date: 2011-09-01 Impact factor: 3.117
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Authors: Robert Folberg; Lu Leach; Klara Valyi-Nagy; Amy Y Lin; Marsha A Apushkin; Zhuming Ai; Vivian Barak; Dibyen Majumdar; Jacob Pe'er; Andrew J Maniotis Journal: Invest Ophthalmol Vis Sci Date: 2007-07 Impact factor: 4.799
Authors: Johanna Winter; Max M Lenders; Maximilian Gassenmaier; Andrea Forschner; Ulrike Leiter; Benjamin Weide; Mette-Triin Purde; Lukas Flatz; Antonio Cozzio; Martin Röcken; Claus Garbe; Thomas K Eigentler; Nikolaus B Wagner Journal: Cancer Immunol Immunother Date: 2020-10-28 Impact factor: 6.968