To report clinical characteristics of uveal melanoma (UM) among Finnish octogenarians.Methods
Population-based study of 86 patients 80 years of age or older, treated in 1997-2011 at the Helsinki University Central Hospital for UM. Patients had a minimum of 2 years follow-up if still alive.Results
Of the 86 patients, 36 (42%) were female and 50 (58%) were male. Median age was 82.9 years (range, 80-93), 5 had a previous nevus, median tumor height was 4.8mm (range, 1.1- 17.9), median largest basal diameter was 12.7 (range, 4.3-22). Following the 7th edition of TNM tumor classification, 33% were T1, 19% T2, 22% T3, and 26% T4, and 28% were stage I, 32% stage II, 33% stage III, and 6% were stage IV (i.e. metastases at diagnosis). 70 patients were treated with brachytherapy (iodine in 38 and ruthenium is 32), 12 underwent primary enucleation, 1 eye was exenterated and 2 small tumours were observed. Median visual acuity was 0.2 (interquartile range, 0.6 to counting fingers) and in the fellow eye 0.7. At last follow-up, 20 patients had died of metastasis, 21 of other causes, 3 of a second cancer (prostate, renal, urinary bladder), death certificate was not yet reviewed in 16, and 26 were alive a median of 5.1 years after treatment (range, 1.4-11.1). The 5-year Kaplan-Meier survival was 75% overall, and 93% for stage I, 79% for stage II, and 62% stage III; all patients of stage IV died within 1.3 years. The corresponding all-cause mortalities were 66%, 55%, and 29%.Conclusion
Taking competing causes of death into account, less than 25% of octogenarians die of uveal melanoma within 5 years.