Conversely, in OM and PT of pCRC in the synchronous group, a higher ratio was associated with longer DFS (HR: 0.53, CI: 0.29-0.98, p = 0.04 and HR: 0.46, CI: 0.25-0.86, p = 0.02, respectively) and TTR.<h4>Conclusions</h4>The high Foxp3+/CD4+ cells ratio was associated with shorter survival in metachronous and longer survival in synchronous disease, providing novel clinical implications. The gene discussed is CD4; the disease is ocular melanoma.