Eye-Sparing Treatment for Diffuse Invasive Conjunctival Melanoma

Chaves, Leandro; Huth, Bradley J.; Augsburger, James J.; Corrêa, Zélia M.

doi:10.1159/000485978

Cited by 23 publications

(11 citation statements)

References 7 publications

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“…The SNLB results were negative for tumor (0 of 1 [0%]). 25 4 0 Vuthaluru et al 29 4 0 Lokdarshi et al 17 3 0 Wainstein et al 30 3 0 Baroody et al 6 2 2 Maalouf et al 18 2 0 Aziz et al 5 1 0 Chaves et al 8 1 1 Medina et al 19 1 0 Motomura et al 20 1 0 Rubinstein et al 24 1 0 Schwarz et al 26 1 0 Wilson et al 31 1 0 Eyelid Pfeiffer et al 21 20 6 Ho et al 15 8 1 Harish et al 13 5 0 Hayashi et al 14 2 2 Maalouf et al 18 2 0 Iwata et al 16 1 0 Rubinstein et al 23 1 0 Rubinstein et al 25 1 0 Turell and Char 28 1 0 Wilson et al 31 1…”

Section: Pigmented Epithelioid Melanocytoid Tumormentioning

confidence: 99%

Sentinel Lymph Node Biopsy for Eyelid and Conjunctival Malignancy

et al. 2020

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Purpose: To determine the efficacy and safety of sentinel lymph node biopsy (SLNB) in the management of eyelid and conjunctival malignancy.Methods: A literature search was performed in August 2019 and January 2020 for articles published in English in the PubMed and Cochrane Library databases. This search yielded 151 articles that were reviewed for relevancy, of which 27 were deemed to have met the inclusion criteria for this assessment. The data from these articles were abstracted and the articles were rated for strength of evidence by the panel methodologist.Results: All 27 studies were rated level III, and a total of 197 SLNBs were reported. Diagnoses included conjunctival and eyelid cutaneous melanoma (85 and 42 patients, respectively), sebaceous gland carcinoma (35 patients), squamous cell carcinoma (26 patients), Merkel cell carcinoma (6 patients), pigmented epithelioid melanocytoid tumor (1 patient), mucoepidermoid carcinoma (1 patient), and signet ring carcinoma (1 patient). Tracer was found in regional lymph nodes in 100% of patients in 21 of 27 articles and in 191 of 197 patients overall. The number of lymph nodes removed ranged from 1 to 16, with most ranging from 1 to 5. Tumor-positive lymph nodes were found in 33 of 197 patients (16.8%), prompting recommendations for adjuvant treatments. Survival data were reported for 16 of these patients, with follow-up periods ranging from 3 to 36 months (average, 12.7 months). Fourteen of 16 patients received adjuvant treatments. Nine were alive and well, 1 was alive with metastases, and 6 had died of metastatic disease (including 2 patients who declined additional treatment). Falsenegative SLNB results were reported in 5 articles involving 9 of 197 procedures (4.6%). Complications were documented in 7 of 27 articles and included transient facial nerve weakness, persistent blue dye staining of the conjunctiva, neck hematoma, and suture abscess.Conclusions: Sentinel lymph node biopsy is a promising procedure in patients with eyelid and conjunctival malignancy, and it is useful in identifying sentinel lymph nodes. However, at present, insufficient evidence exists showing that SLNB improves patient outcomes and survival. Recognition of microscopic metastatic disease may prove beneficial in staging and guiding adjuvant therapy. Ophthalmology 2020;127:1757-1765 ª 2020 by the American Academy of Ophthalmology No animal subjects were included in this study.

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Section: Pigmented Epithelioid Melanocytoid Tumormentioning

confidence: 99%

Sentinel Lymph Node Biopsy for Eyelid and Conjunctival Malignancy

et al. 2020

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“…Systemic immunotherapies widely used in cutaneous melanoma for several years could also be beneficial to patients with metastatic CM [ 44 , 112 , 113 , 116 , 117 , 118 ];…”

Section: Future Perspectivesmentioning

confidence: 99%

Small but Challenging Conjunctival Melanoma: New Insights, Paradigms and Future Perspectives

Nahon-Estève

Bertolotto

Picard‐Gauci

et al. 2021

Cancers

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Although its incidence has increased over the last decades, conjunctival melanoma (CM) remains a rare but challenging periocular malignancy. While there is currently no recognized standard of care, “no-touch” surgical excision followed by adjuvant treatments is usually recommended. Despite its small size, managing CM is challenging for clinicians. The first challenge is the high risk of tumour local recurrence that occurs in about one third of the patients. The management of locally advanced CM (≥T2) or multiple recurrences may require mutilating surgeries such as orbital exenteration (OE). The second challenge is the metastatic spread of CM that occurs in about one quarter of patients, regardless of whether complete surgical excision is performed or not. This highlights the infiltrative and highly aggressive behaviour of CM. Recently, attention has been directed towards the use of eye-sparing strategies to avoid OE. Initially, wide conservative surgeries followed by customized brachytherapy or radiotherapy have appeared as viable strategies. Nowadays, new biological insights into CM have revealed similarities with cutaneous melanoma. These new findings have allowed clinicians to reconsider the management of locally advanced CM with “medical” eye-sparing treatment as well as the management of metastatic spread. The aim of this review was to summarize the current and future perspectives of treatment for CM based on recent biological findings.

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“…11,21,23,25,32,48,51,53 Few reports regarding the immunological features of this disease are available. [83][84][85][86][87][88] Cao conducted a study to evaluate the PD-1/PD-L1 pathway in conjunctival melanoma. In sections of 27 human conjunctival melanomas, it has been found that 19% of the melanoma cells and 59% of the stromal cells expressed PD-L1 (≥5%) on their membrane.…”

Section: Immune Checkpoint Inhibitors For Conjunctival Melanomamentioning

confidence: 99%

“…87 In the adjuvant setting, ipilimumab was administered to a patient with conjunctival melanoma who did not experience a recurrence for 16 months. 88 Although the limited data, ICIs can be considered for the treatment of advanced conjunctival melanoma.…”

Section: Immune Checkpoint Inhibitors For Conjunctival Melanomamentioning

confidence: 99%