OBJECTIVE: To study the relevance of liver function test (LFT) results for early detection of liver metastasis of uveal melanoma. DESIGN: Evaluation of diagnostic test. PARTICIPANTS: Eighty-eight patients were included in whom metastasis developed while undergoing semiannual follow-up with LFTs, including aspartate-aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyltransferase (γGT), lactate dehydrogenase (LDH), and phosphatase alkaline (PA). As controls, 174 patients with uveal melanoma without metastasis were included. METHODS: The diagnostic attributes of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each test were estimated from cross-tabulation tables of test results according to the diagnosis of metastasis. The proportions of false-positive results between groups of patients with and without metastasis were compared in log-binomial regression models. MAIN OUTCOME MEASURES: Sensitivity, specificity, PPV, NPV, and cost evaluation. RESULTS: Metastases were detected after LFT abnormality (at least 1 abnormal test result) in 40 (45%) patients. The overall sensitivity of LFTs ranged from 12.5% to 58.0%, and the PPV ranged from 9.4% to 38.6%. The overall specificity and NPV were 90% or greater. The proportions of false-positive results between groups of patients with and without metastasis did not differ significantly (all P≥0.38). Using a cost evaluation, semi-annual screening by LFTs was calculated to cost $35.5/year per patient, including liver imaging induced by true and false-positive results. CONCLUSIONS: Isolated or combined LFTs for AST, ALT, γGT, LDH, and PA are not helpful for detection of early metastasis. However, the high NPVs suggest that LFT screening can allow clinicians to reassure the patient when the LFT results are negative.
OBJECTIVE: To study the relevance of liver function test (LFT) results for early detection of liver metastasis of uveal melanoma. DESIGN: Evaluation of diagnostic test. PARTICIPANTS: Eighty-eight patients were included in whom metastasis developed while undergoing semiannual follow-up with LFTs, including aspartate-aminotransferase (AST), alanine aminotransferase (ALT), gamma glutamyltransferase (γGT), lactate dehydrogenase (LDH), and phosphatase alkaline (PA). As controls, 174 patients with uveal melanoma without metastasis were included. METHODS: The diagnostic attributes of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for each test were estimated from cross-tabulation tables of test results according to the diagnosis of metastasis. The proportions of false-positive results between groups of patients with and without metastasis were compared in log-binomial regression models. MAIN OUTCOME MEASURES: Sensitivity, specificity, PPV, NPV, and cost evaluation. RESULTS:Metastases were detected after LFT abnormality (at least 1 abnormal test result) in 40 (45%) patients. The overall sensitivity of LFTs ranged from 12.5% to 58.0%, and the PPV ranged from 9.4% to 38.6%. The overall specificity and NPV were 90% or greater. The proportions of false-positive results between groups of patients with and without metastasis did not differ significantly (all P≥0.38). Using a cost evaluation, semi-annual screening by LFTs was calculated to cost $35.5/year per patient, including liver imaging induced by true and false-positive results. CONCLUSIONS: Isolated or combined LFTs for AST, ALT, γGT, LDH, and PA are not helpful for detection of early metastasis. However, the high NPVs suggest that LFT screening can allow clinicians to reassure the patient when the LFT results are negative.
Authors: Maria Lucia Calcagni; Maria Vittoria Mattoli; Maria Antonietta Blasi; Gianluigi Petrone; Maria Grazia Sammarco; Luca Indovina; Antonino Mulè; Vittoria Rufini; Alessandro Giordano Journal: Eur J Nucl Med Mol Imaging Date: 2013-07-04 Impact factor: 9.236
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
Authors: Amy C Schefler; Alison Skalet; Scott Cn Oliver; John Mason; Anthony B Daniels; Katherina M Alsina; Kristen M Plasseraud; Federico A Monzon; Brian Firestone Journal: Melanoma Manag Date: 2020-03-11