Ocular conservation in patients with uveal melanoma by a multimodality approach to treatment

Abstract

Purpose: To analyse eye survival in patients with uveal melanoma with a multimodality approach to treatment Methods: 273 patients with uveal melanoma diagnosed at Ocular Oncology Unit of the University Hospital of Valladolid from 1997 September to 2007 April. Pearson’s Chi‐square test was used to identify between variables and primary enucleation. Logistic regression was used to identify independent variables predicting primary enucleation. Cox’s univariate proportional hazards model was used to identify associations between variables and time to secondary enucleation.Kaplan‐Meier estimates were used to draw survival curves for time to secondary enucleation Results: 273 patients were included in the study. Primary enucleation was performed in 80 patients. Secondary enucleation in 12. Gender (p=0,032), basal tumour diameter >15mm (p<0,001), tumour weight >10mm (p<0,001), anterior tumour margin (p<0,001) and extraocular spread (p<0,001) were associated with primary enucleation. Predictive factors for primary enucleation were largest basal tumor diameter (odds ratio [OR], 3,8; 95% confidence interval [IC], 1,5‐9,1) and tumour weight (OR, 2,7; IC, 1‐7,5). Ocular conservation probability 5 years after conservative treatment was 88%. Largest basal tumor diameter, anterior tumour margin and extraocular spread had influence in ocular survival after conservative treatment. Only largest basal tumor diameter was a predictive factor of secondary enucleation Conclusions: In the present series 69,9% of patiens had a conservative treatment and 88% of them conserved treated eye 5 years

JARID1B Protein Expression and Prognostic Implications in Uveal Melanoma

“…[6][7][8][9][10][11][12] Once metastases are detected, median life expectancy is reduced to approximately 2 to 9 months, irrespective of treatment. [9][10][11][12][13][14][15] UM is characterized by constitutive chemoresistance that can only be partially explained by a complex multidrug resistance (MDR) phenotype and several chemoresistancerelated antiapoptotic proteins. 16 Current therapeutic regimes that predominantly target the rapidly proliferating tumor bulk, such as systemic chemotherapy and dacarbazine (DTIC)-based chemotherapies, have had a limited effect and showed to be for those patients with a metastatic spreading of the disease.…”

Uveal vs. cutaneous melanoma. Origins and causes of the differences

“…Unfortunately, current clinical tests fail in detecting metastatic disease at an early stage [14]. Once the disease has metastasised, life expectancy is reduced to <1 year [15]. Treatment options for patients with clinically disseminated disease are scarce and usually unsuccessful.…”