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• W4224022009 abstract "We appreciate the comments of Coupland et al, reminding us of their magnificent work in prognostication of uveal melanoma using their online system, the Liverpool Uveal Melanoma Prognosticator Online (LUMPO).1Damato B. Eleuteri A. Hussain R. et al.Parsimonious models for predicting mortality from choroidal melanoma.Invest Ophthalmol Vis Sci. 2020; 61: 35Crossref PubMed Scopus (12) Google Scholar When one knows specific clinical, histopathologic, and/or genetic characteristics of a uveal melanoma, one can enter these online and not only obtain a prediction for survival of that specific case, but also a comparison with persons of the same age and gender. An extensive description of LUMPO has been provided by Dr Damato in a recent comprehensive review entitled “Uveal Melanoma.”2Jager M.J. Shields C.L. Cebulla C.M. et al.Uveal melanoma.Nat Rev Dis Primers. 2020; 6: 1-24Crossref PubMed Scopus (300) Google Scholar As stated, the next Tumor Node Metastasis/American Joint Committee on Cancer (TNM/AJCC) staging system may benefit from adding genetic information. We considered combining the 2 systems when we realized that several studies (including our own) compared or added the effect of individual risk factors, but did not incorporate the 2 main complementary staging systems.1Damato B. Eleuteri A. Hussain R. et al.Parsimonious models for predicting mortality from choroidal melanoma.Invest Ophthalmol Vis Sci. 2020; 61: 35Crossref PubMed Scopus (12) Google Scholar,3Bagger M. Andersen M.T. Andersen K.K. et al.The prognostic effect of American Joint Committee on Cancer Staging and genetic status in patients with choroidal and ciliary body melanoma.Invest Ophthalmol Vis Sci. 2014; 56: 438-444Crossref PubMed Scopus (39) Google Scholar,4Walter S.D. Chao D.L. Feuer W. et al.Prognostic implications of tumor diameter in association with gene expression profile for uveal melanoma.JAMA Ophthalmol. 2016; 134: 734-740Crossref PubMed Scopus (95) Google Scholar Our results demonstrate that combining the AJCC clinical classification with the TCGA genetic classification improves the level of prognostication, even in small tumors. We show that the number of copies of chromosome 8q is indeed relevant, as we observed a significant difference between groups C and D, both of which have loss of chromosome 3 but differ in 8q copy number. We agree with Coupland et al that future classification systems should not simply include information about clinical and/or histopathologic tumor characteristics, but also incorporate genetic information following conservative needle biopsy or enucleation. As shown with LUMPO, which is now employing version 3, one needs to adjust classification systems as knowledge expands. To further this point, we observed that iris color influences the impact of genetic prognostic factors of chromosome 3 and 8q. Loss of chromosome 3 or additional copies of 8q had a greater influence on survival in uveal melanoma patients of European descent with blue or green irides compared with patients having brown irides.5Wierenga A.P.A. Brouwer N.J. Gelmi M.C. et al.Chromosome 3 and 8q aberrations in uveal melanoma show greater impact on survival in patients with light iris versus dark iris color.Ophthalmology. 2022; 129: 421-430Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar We hope this information is validated by other studies worldwide, and, if so, one might consider adding iris color to prognostication systems as well. Re: Gelmi et al.: Adding The Cancer Genome Atlas Chromosome Classes to American Joint Committee on Cancer System offers more precise prognostication in uveal melanoma (Ophthalmology. 2022:129:431-437)OphthalmologyVol. 129Issue 7PreviewGelmi et al1 published an article in which they suggest improving prediction of metastatic disease from uveal melanoma by combining chromosome 3 loss and 8q gain with Tumor Node Metastasis/American Joint Committee on Cancer (TNM/AJCC) staging.1 Full-Text PDF" @default.
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• W4224022009 date "2022-07-01" @default.
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• W4224022009 doi "https://doi.org/10.1016/j.ophtha.2022.02.032" @default.
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