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Updated: May 6, 2026
Analysis of Lymph Node Volume by Ultra-High-Frequency Ultrasound Imaging in the Braf/Pten Genetically Engineered Mouse Model of Melanoma
Published on: September 8, 2021
Continuous tumour volume improves prognostic stratification beyond AJCC stage and MLPA cytogenetic profile in uveal
Armando Gutiérrez-Cuesta1, Manuel F Bande2,3, Paula Silva-Rodríguez4
1Department of Ophthalmology, Complexo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Spain.
Purpose:
To evaluate the prognostic value of estimated tumour volume as a continuous biomarker in uveal melanoma and to compare its discriminative performance with the American Joint Committee on Cancer (AJCC) staging and multiplex ligation-dependent probe amplification (MLPA)-based genetic risk classification.
Methods:
This retrospective cohort study included consecutive patients with choroidal or ciliary body melanoma treated between 2016 and 2024 at a tertiary ocular oncology centre. Tumour volume (mm³) was calculated from baseline ultrasonography using an ellipsoidal (oval-base) approximation. The primary endpoint was metastasis-free survival (MFS). Survival was analysed using Kaplan-Meier methods and Cox regression. In the genetic subset, Firth-penalised Cox regression was applied. Prognostic discrimination was assessed using Harrell's concordance index (C-index) for AJCC stage, tumour volume, MLPA profile and combined models.
Results:
A total of 237 patients were included (mean age 65.5±13.8 years; 54.0% female). Median follow-up was 61.0 months, and 64 patients developed metastasis during follow-up. Higher tumour volume was significantly associated with worse MFS, corresponding to an approximately 10% increase in hazard per 100 mm³ (HR 1.10; 95% CI 1.05 to 1.13; p<0.001). Continuous tumour volume showed higher discrimination than AJCC staging alone (C-index 0.73 vs 0.66). The highest discrimination was observed in models combining tumour volume and MLPA profile, with limited additional gain after including AJCC stage (C-index 0.79 in the MLPA subset).
Conclusions:
Continuous tumour volume provides more refined prognostic stratification in uveal melanoma and complements AJCC staging. Integrating volumetric, anatomic and molecular biomarkers improves risk assessment and may support individualised surveillance strategies.
