{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T04:05:13Z","timestamp":1777953913531,"version":"3.51.4"},"reference-count":21,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,4,20]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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 (mm\u00b3) 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\u2019s concordance index (C-index) for AJCC stage, tumour volume, MLPA profile and combined models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 237 patients were included (mean age 65.5\u00b113.8 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\u2009mm\u00b3 (HR 1.10; 95%\u2009CI 1.05 to 1.13; p&lt;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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2026-329615","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T17:20:18Z","timestamp":1777915218000},"page":"bjo-2026-329615","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Continuous tumour volume improves prognostic stratification beyond AJCC stage and MLPA cytogenetic profile in uveal melanoma"],"prefix":"10.1136","author":[{"given":"Armando","family":"Guti\u00e9rrez-Cuesta","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Complexo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0386-4149","authenticated-orcid":false,"given":"Manuel F","family":"Bande","sequence":"additional","affiliation":[{"name":"Surgical Retina and Adult Intraocular Tumors Unit, Department of Ophthalmology, Complexo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Coru\u00f1a, Spain"},{"name":"University of Santiago de Compostela, Santiago de Compostela, Spain, Santiago de Compostela, Coru\u00f1a, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Silva-Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n P\u00fablica Galega de Medicina Xen\u00f3mica, CHUS\/SERGAS, Santiago de Compostela, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Purificaci\u00f3n","family":"Mera","sequence":"additional","affiliation":[{"name":"Surgical Retina and Adult Intraocular Tumors Unit, Department of Ophthalmology, Complexo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Coru\u00f1a, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joaqu\u00edn","family":"Marticorena","sequence":"additional","affiliation":[{"name":"Surgical Retina and Adult Intraocular Tumors Unit, Department of Ophthalmology, Complexo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Coru\u00f1a, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda","family":"Pardo","sequence":"additional","affiliation":[{"name":"Grupo Obesid\u00f3mica, Laboratorio de Endocrinolog\u00eda Molecular y Celular, Hospital Cl\u00ednico Universitario de Santiago (CHUS\/SERGAS), Spain, Santiago de Compostela, Coru\u00f1a, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda Jos\u00e9","family":"Blanco-Teijeiro","sequence":"additional","affiliation":[{"name":"Surgical Retina and Adult Intraocular Tumors Unit, Department of Ophthalmology, Complexo Hospitalario Universitario de Santiago (CHUS), Santiago de Compostela, Coru\u00f1a, Spain"},{"name":"University of Santiago de Compostela, Santiago de Compostela, Spain, Santiago de Compostela, Coru\u00f1a, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"2026050410201172000_bjo-2026-329615v1.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2011.01.040"},{"key":"2026050410201172000_bjo-2026-329615v1.2","doi-asserted-by":"publisher","DOI":"10.1158\/0008-5472.CAN-04-1750"},{"key":"2026050410201172000_bjo-2026-329615v1.3","doi-asserted-by":"crossref","unstructured":"Harbour JW , Chen R . 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Artificial intelligence-assisted assessment of metabolic response to tebentafusp in metastatic uveal melanoma: a long axial field-of-view [(18)F]FDG PET\/CT study. 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