Prognostic factors following enucleation of 111 uveal melanomas.

Coleman, Kate; Baak, J. P. A.; Diest, PJ van; Mullaney, Joan; Farrell, Michael J.; Fenton, M.

doi:10.1136/bjo.77.11.688

Cited by 57 publications

(39 citation statements)

References 18 publications

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“…The postbrachytherapy follow up included A-scan and B-scan ultrasonography and a clinical examination (including metastatic evaluation) 3 months after the surgery and every 6.6 (0.3) (mean (SE)) months thereafter (a total of 1001 examinations). Each patient was examined on average 5.6 times (range [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Thirty three of the 147 patients died during the…”

Section: Resultsmentioning

confidence: 99%

“…8 9 Thus, it is important to define clinical factors predictive of metastatic spread. Such unfavourable prognostic parameters include a larger tumour diameter, 10 a faster growing tumour, 11 presence of extrascleral growth, tumour margin location anterior to the equator of the eye, 12 ciliary body involvement, 13 older age, 10 male sex, 10 tumour induced glaucoma, 14 and specific microvascular patterns 10 15 which can be assessed clinically either by confocal indocyanine green angiography [16][17][18] or ultrasound backscatter parameters. 19 We have previously shown that, following brachytherapy, larger tumours shrink significantly faster than smaller ones.…”

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confidence: 99%

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Post-brachytherapy initial tumour regression rate correlates with metastatic spread in posterior uveal melanoma

Kaiserman

Anteby²,

Chowers³

et al. 2004

British Journal of Ophthalmology

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Aim: To confirm the prognostic value of post-brachytherapy initial tumour regression rate in posterior uveal melanoma. Methods: A prospective, comparative, observational cohort study was carried out on 147 eyes (147 patients) with choroidal melanoma (mean age 61 years) treated with Ru-106 brachytherapy. Observation procedure: Patients were followed clinically and ultrasonically every 6.7 (SD 0.3) months (1001 examinations). On average each patient was examined 5.8 times (mean follow up 9.6 (3.7) years). The echographic parameters included tumour base size, height, internal reflectivity, regularity, vascularity, and extrascleral extension. The clinical follow up included ocular examination and periodic metastatic screening (liver function tests and liver imaging). Main outcome measures were risk of liver metastasis in correlation with the post-brachytherapy initial tumour regression rate. Results: At brachytherapy the mean tumour height was 5.2 mm (range 2.2-11.8 mm). After brachytherapy 142 tumours (96.6%) responded by a decrease in height. The initial height regression rate was 6.1% (0.8%) per month in patients who later developed metastasis v 4.3% (0.4%) per month in those who did not. Tumours higher than 6 mm, tumours with an internal reflectivity smaller than 50%, and tumours with an initial rate of height regression larger than 0.7 mm/month (10% per month) had higher 5 year melanoma related mortality. Kaplan-Meier survival analysis and the multivariate Cox proportional hazards model showed a significant role for tumour height and initial tumour regression rate on patients' survival. Conclusion: This study confirms that post-brachytherapy initial tumour regression rate has a prognostic value.

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Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

Post-brachytherapy initial tumour regression rate correlates with metastatic spread in posterior uveal melanoma

Kaiserman

Anteby²,

Chowers³

et al. 2004

British Journal of Ophthalmology

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“…28 This classification, the Linear LBD, has been used in multiple publications since that time. [4][5][6] This classification has only one size parameter, making it the easiest among the tumor size classifications evaluated in this study to use. Although we could find no explanation why LBD of 10 and 15 mm were selected as boundary lines for this classification, our study shows this classification system to be the best prognostic indicator of metastasis-free survival by the log rank test of trend.…”

Section: Discussionmentioning

confidence: 99%

“…[4][5][6][8][9][10][11][12][13][15][16][17]20,23 The authors formed a three-category Rectangular LBD 3 TH classification by combining two ''two-category'' LBD 3 TH classifications (one defining a ''small'' tumor as LBD 3 TH 30 mm 2 and regarding all others as large, 24 another defining a ''large'' tumor as LBD 3 TH >100 mm 2 and regarding all others as small). 19 Finally, two additional three-category classifications were created by merging subgroups of the four-category TNM 2010 classification 25 as follows: TNM 2010a combined T1 and T2 subgroups, and TNM 2010b combined T2 and T3 subgroups.…”

Section: Methodsmentioning

confidence: 99%

“…Some classifications use largest basal diameter (LBD) of the tumor alone, [4][5][6][7] many take into account both LBD and tumor thickness (TH), [8][9][10][11][12][13][14][15][16][17][18][19] and at least one takes into account smallest basal diameter (SBD) as well as LBD and TH. [20][21][22] This study was designed to evaluate multiple reported and some derived tumor size classifications of PUM that separate tumors into small, medium, and large categories and determine which three-size category classification provides the best prediction of low, intermediate, and high risk for metastasis.…”

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confidence: 99%

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Comparison of Alternative Tumor Size Classifications for Posterior Uveal Melanomas

Skinner

Augsburger

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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Reduced Melanoma-Related Mortality in Uveal Melanoma by Preenucleation Radiotherapy

Kılıç

Stijnen²,

Jong³

et al. 2005

Arch Ophthalmol

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Background: Radiotherapy of an eye before enucleation, so called preenucleation radiotherapy (PER), of patients with uveal melanoma was initiated to reduce enucleation-induced systemic metastasis. Earlier studies with a short follow-up period have not demonstrated a significant effect on survival. Objective: To study the effect of PER on melanomarelated mortality after more than 9 years of follow-up. Design: In a prospective study, 167 patients with uveal melanoma were treated between 1978 and 1992 by irradiation with 800 rad (8 Gy) given in 2 fractions 2 days before enucleation. A group of 108 patients with uveal melanoma treated between 1971 and 1992 by enucleation only in the same hospital served as a historical control group. Patients were followed up until December 2002 or death. Results: Melanoma-related death occurred in 32.3% of the PER-treated group and in 40.7% of the enucleation only group. Mean follow-up was 9.25 years. After 48 months of follow-up, a significant difference in survival became evident in favor of the PER group. The estimated 15-year survival rates for patients with melanoma in the PER group and enucleation only group were 63.7% and 51.0%, respectively. For patients dying of all causes, these percentages were 47.5% and 25.2%, respectively. In both groups, women had a better prognostic outcome than men. Conclusion: This study suggests that PER improves longterm survival in patients with uveal melanoma.

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Prognostic factors following enucleation of 111 uveal melanomas.

Cited by 57 publications

References 18 publications

Post-brachytherapy initial tumour regression rate correlates with metastatic spread in posterior uveal melanoma

Post-brachytherapy initial tumour regression rate correlates with metastatic spread in posterior uveal melanoma

Comparison of Alternative Tumor Size Classifications for Posterior Uveal Melanomas

Reduced Melanoma-Related Mortality in Uveal Melanoma by Preenucleation Radiotherapy

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