Plaque brachytherapy is an effective eye and vision-sparing method to treat patients with intraocular tumors. Practitioners are encouraged to use ABS-OOTF guidelines to enhance their practice.

The AJCC Ophthalmic Oncology Task Force IMPORTANCE Although an accurate uveal melanoma staging system is needed to improve research and patient care, the evaluation of eye cancer staging systems requires international multicenter data sharing to acquire a statistically significant analysis. OBJECTIVE To assess patient mortality outcomes associated with uveal melanoma staging according to the 7th edition of the American Joint Committee on Cancer's AJCC Cancer Staging Manual. DESIGN, SETTING, PARTICIPANTS A committee was formed to create patient-specific data fields for patients with uveal melanoma. Ten subspecialty ophthalmic oncology centers from 4 continents shared data. Patient selection criteria included diagnosis of uveal melanoma from April 1, 2001, to April 1, 2011, adequate records to allow tumor staging by the AJCC criteria, and follow-up for metastatic melanoma. INTERVENTIONS Primary treatments included local resection, radiation therapy, and enucleation. MAIN OUTCOMES AND MEASURES Metastasis after initial tumor staging with 5-and 10-year Kaplan-Meier metastasis-free point estimates, depending on AJCC prognostic stages I through IV, tumor size category, and subclassification (defined by the presence of ciliary body involvement and/or extrascleral extension). RESULTS A total of 3809 patients were entered into the database. Of these, 3377 records (88.7%) were complete. Primary ciliary body and choroidal melanoma was the diagnosis for 3217, and 160 had primary iris melanoma. Tumor size categories were T1 in 1115 (34.7%) of the 3217 patients, T2 in 1128 patients (35.1%), T3 in 789 patients (24.5%), and T4 in 185 patients (5.8%). The 5-and 10-year Kaplan-Meier metastasis-free point estimates by tumor size categories were 97% (95% CI, 95%-98%) and 94% (95% CI, 91%-96%) for T1 tumors, 85% (95% CI, 82%-88%) and 80% (95% CI, 75%-84%) for T2 tumors, 77% (95% CI, 73%-80%) and 68% (95% CI, 60%-74%) for T3 tumors, and 61% (95% CI, 49%-71%) (5-year only) for T4 tumors, respectively. Increasing tumor size was consistent with increased metastasis risk (P < .001). Subclassifications were significantly associated with increased risk of metastasis (P < .001). The AJCC prognostic and anatomical groupings were as follows: stage I, 1030 (32.0%); stage IIA, 1095 (34.0%); stage IIB, 710 (22.1%); stage IIIA, 282 (8.8%); stage IIIB, 79 (2.5%); and stage IIIC, 21 (0.7%). The 5-and 10-year Kaplan-Meier metastasis-free estimates for prognostic stages were 97% (95% CI, 95%-98%) and 94% (95% CI, 91%-96%) for stage I, 89% (95% CI, 86%-91%) and 84% (95% CI, 80%-88%) for stage IIA, 79% (95% CI, 75%-83%) and 70% (95% CI, 62%-76%) for stage IIB, 67% (95% CI, 59%-73%) and 60% (95% CI, 51%-68%) for stage IIIA, 50% (95% CI, 33%-65%) and 50% (95% CI, 33%-65%) for stage IIIB, and 25% (95% CI, 4%-53%) (5-year only) for stage IIIC, respectively. The 160 iris melanomas were too few for subgroup analysis. CONCLUSIONS AND RELEVANCE Multicenter, worldwide, Internet-based data sharing was used to study a heterogenous patient population in ophthalmic o...

International multicenter data sharing was used to evaluate the effect of local tumor recurrence on metastatic rate. In that local tumor recurrence was associated with a significantly higher risk of systemic metastasis, effective initial treatment and long-term surveillance of treated uveal melanoma patients is necessary.

ObjectiveTo analyse ocular and systemic findings of patients presenting with systemic metastasis.Methods and analysisIt is an international, multicentre, internet-enabled, registry-based retrospective data analysis. Patients were diagnosed between 2001 and 2011. Data included: primary tumour dimensions, extrascleral extension, ciliary body involvement, American Joint Committee on Cancer (AJCC)-tumour, node, metastasis staging, characteristics of metastases.ResultsOf 3610 patients with uveal melanoma, 69 (1.9%; 95% CI 1.5 to 2.4) presented with clinical metastasis (stage IV). These melanomas originated in the iris, ciliary body and choroid in 4%, 16% and 80% of eyes, respectively. Using eighth edition AJCC, 8 (11%), 20 (29%), 24 (35%), and 17 (25%) belonged to AJCC T-categories T1–T4. Risk of synchronous metastases increased from 0.7% (T1) to 1.5% (T2), 2.6% (T3) and 7.9% (T4). Regional lymph node metastases (N1a) were detected in 9 (13%) patients of whom 6 (67%) had extrascleral extension. Stage of systemic metastases (known for 40 (59%) stage IV patients) revealed 14 (35%), 25 (63%) and 1 (2%) had small (M1a), medium-sized (M1b) and large-sized (M1c) metastases, respectively. Location of metastases in stage IV patients were liver (91%), lung (16%), bone (9%), brain (6%), subcutaneous tissue (4%) and others (5%). Multiple sites of metastases were noted in 24%. Compared with the 98.1% of patients who did not present with metastases, those with synchronous metastases had larger intraocular tumours, more frequent extrascleral extension, ciliary body involvement and thus a higher AJCC T-category.ConclusionsThough higher AJCC T-stage was associated with risk for metastases at diagnosis, even small T1 tumours were stage IV at initial presentation. The liver was the most common site of metastases; however, frequent multiorgan involvement supports initial whole-body staging.

This study confirms that children with CCBM have a more favorable survival than young adults 18 to 25 years of age, adjusting for TNM stage and gender. The association between gender and survival varies between age groups.

Uveal melanoma is a malignant intraocular tumor associated with poor vital prognosis, process generalization, and death from metastatic disease. A number of factors are considered undesirable in the presence of a tumor. This paper provides a review of the literature on major prognostic factors for uveal melanoma development and their contribution to vital prognosis.

ель исследования. Оценить роль современных методов исследования в ран-ней диагностике метастазов у пациентов с увеальной меланомой (УМ). Материалы и методы. Обследовано 70 больных (22 мужчины, 48 женщин) в возрасте от 26 до 78 лет (средний возраст 52 ± 13 лет) с диагнозом УМ: 40 из них до начала лечения, 30 -в сроки от 3 до 178 месяцев (медиана 25 ± 9,5 мес.) после оконча-ния лечения. Для скрининга метастатической болезни всем пациентам проводились следующие исследования: клиническое обследование, определение уровня печеночных ферментов, рентгенография органов грудной клетки (ОГК), ультразвуковое исследова-ние (УЗИ) органов брюшной полости (ОБП), позитронно-эмиссионная томогра-фия/компьютерная томография (ПЭТ/КТ) в режиме «всего тела» с 18 -фтор-2-дезокси-D-глюкозой (18F-ФДГ).Результаты и обсуждение. Показатели уровня печеночных ферментов оказа-лись повышены у одного больного с диссеминированным поражением. По данным рентгенографии ОГК у одного больного были обнаружены фиброзные очаговые измене-ния в легких (после перенесенного туберкулеза). По данным УЗИ ОБП множественное поражение (метастазы) печени выявлено у одного больного, у другой пациентки заподо-зрен вторичный характер поражения (в дальнейшем диагностирована киста), у 11 больных образования в печени расценивались как кисты или гемангиомы. По данным ПЭТ/КТ метастазы в печени выявлены у 6 пациентов (2 -солитарное, 4 -множествен-ное). У одного из этих пациентов также обнаружен очаг поражения в сигмовидной кишке, в дальнейшем верифицирован как аденокарцинома (синхронный рак). В одном случае, помимо очагов в печени, были выявлены множественные метастазы в других органах (легкие, кости, брюшина, забрюшинное пространство, петли кишечника). У 14 (22%) больных обнаружены очаговые изменения в легких малых размеров (менее 5 мм) неизвестной этиологии -рекомендовано наблюдение в динамике (КТ контроль). По дан-ным ПЭТ/КТ также обнаруживались сопутствующие (воспалительные, доброкачествен-ные, дегенеративно-дистрофические) изменения.Заключение. ПЭТ/КТ в сравнении со стандартными методами исследования имеет преимущества в ранней диагностике метастатической УМ, однако при этом не является методом выбора в диагностике первичной УМ.Ключевые слова: увеальная меланома, метастаз, диагностика, УЗИ органов брюшной полости, рентгенография органов грудной клетки, ПЭТ/КТ.

Chromosome 3 monosomy is associated with lower survival rates, while RASSF1A methylation - with a better prognosis. A combination of molecular and genetic changes (particularly, chromosome 3 monosomy and chromosome 1p deletion) also leads to reduced survival in UM patients.