COMS: Better tests needed for metastasis of choroidal melanoma

Tests with higher sensitivity than liver function testing are needed to identify early metastatic disease associated with choroidal melanoma, according to data from a large study. The use of liver function test results and other diagnostic tests have high specificity and predictive value but low sensitivity, the authors of the Collaborative Ocular Melanoma Study said.

Marie Diener-West, PhD, and colleagues analyzed data on 2,320 patients enrolled in the COMS to determine the predictive value of liver function tests, chest x-rays and diagnostic imaging for detecting melanoma metastasis during follow-up of treatment for choroidal melanoma.

Of 714 patients with clinical reports of metastasis, 675 died. All but four of the patients who died had either confirmed or suspected metastatic melanoma present at the time of death. The 5-year diagnosis rate of metastatic melanoma for all patients was 24%.

The sensitivity with at least one liver function test before diagnosis at any site was 14.7%. The specificity of the test was 92.3%, and the predictive value was 71%, the authors said.

The study is published in the June 15 issue of Journal of Clinical Oncology.