Forty-year prognosis after plaque brachytherapy of uveal melanoma

In this study, the long-term patient survival after plaque brachytherapy of uveal melanoma is examined. All patients treated between 1980 and 1999 at a single institution were included (n = 677). 533 (79%) had deceased before the end of follow-up. The median follow-up for the 144 survivors was 25.4 years (SD 5.2). Uveal melanoma-related mortality was 18% by 5 years, 28% by 10 years, 32% by 15 years, 35% by 20 years, and 36% by 25 to 40 years. 172 of 209 (82%) uveal melanoma-related deaths occurred within the first decade after brachytherapy. Relative survival rates were 74% at 5 years, 64% at 10 years, 62% at 20 years, 83% at 30 years and ≥100% at 32 to 40 years. Tumor diameter and local recurrence were independent predictors of uveal melanoma-related mortality in multivariate Cox proportional hazards analysis. In conclusion, uveal melanoma has a high mortality rate and most uveal melanoma-related deaths occur in the first decade after treatment. Long-term survivors may have a survival advantage to individuals of the same sex and age from the general population.