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Your doc might bring up this study to in favor of saving someone money by not having regular CT scans. Notice how weakly the conclusion is stated: "Monitoring the changes in selected LFTs, even within normal limits, can help predict metastatic uveal melanoma". Can you really afford to put your life in more danger based on a statement like that? If you've been diagnosed with uveal melanoma, get regular CT scans!

Am J Ophthalmol. 2004 Feb;137(2):236-43.

Liver function tests in metastatic uveal melanoma. Kaiserman I, Amer R, Pe'er J. Department of Ophthalmology, Hadassah University Hospital, Jerusalem, Israel. Igork@cc.huji.ac.il

PURPOSE: To evaluate trends in liver function tests before detection of liver metastases from uveal melanoma.

DESIGN: Retrospective, comparative, observational case control study. METHODS: Setting: The Israel uveal melanoma center at the Hadassah University Hospital. Patient Population: A total of 307 uveal melanoma patients who were diagnosed with uveal melanoma and followed between the years 1988 and 1998. Of them, 30 metastatic patients who had regular follow-up by liver function tests (LFTs) and liver imaging were included in this study. Eighty nonmetastatic patients were randomly chosen as controls. Observation Procedure: The medical records of the metastatic and control groups were reviewed documenting LFTs and liver imaging results. Main Outcome Measures: The mean level of each LFT, its sensitivity, specificity, and likelihood ratio at various time periods before the detection of metastases by liver imaging.

RESULTS: At the time of diagnosis of liver metastases by imaging, 50% of patients had at least one abnormal LFT (compared with only 5% of the control group). While no change was noted in the mean serum levels of bilirubin, mean lactate dehydrogenase (LDH), alkaline-phosphatase, gamma glutamyl transpeptidase (gamma GTP) aspartate-aminotrasferase, and alanine-aminotrasferase levels seem to rise, even within normal limits, during the 6 months before the detection of metastases. Based on likelihood ratios, alkaline-phosphatase and lactate dehydrogenase were the most predictive tests. Lactate dehydrogenase and aspartate-aminotransferase were already predictive at 80% of the upper normal limit, whereas alkaline-phosphatase and gamma-glutamyltransferase were most predictive at the upper normal limit.

CONCLUSIONS: Monitoring the changes in selected LFTs, even within normal limits, can help predict metastatic uveal melanoma. PMID: 14962411 [PubMed - indexed for MEDLINE]

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