American Joint Committee on Cancer Classification of Posterior Uveal Melanoma (Tumor Size Category) Predicts Prognosis in 7731 Patients

Shields, Carol L.; Kaliki, Swathi; Furuta, Minoru; Fulco, Enzo; Alarcón, Carolina; Shields, Jerry A.

doi:10.1016/j.ophtha.2013.03.012

Cited by 121 publications

(104 citation statements)

References 16 publications

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“…On the basis of multivariate analysis, the rate of metastasis increased with increasing age (Po0.001), ciliary body location (Po0.001), increasing tumor base (Po0.001), increasing tumor thickness (Po0.001), pigmented tumor (P = 0.001), subretinal fluid (P = 0.001), intraocular hemorrhage (P = 0.045), and extraocular extension (P = 0.036). KaplanMeier estimates of metastasis at 3, 5, and 10 were 8,15, and 25% in Caucasians;13,13, and 13% in Hispanics;4,4, and 36% in Asians;and 8,8, and 8% in African Americans. Compared with Caucasians, despite relative risk for metastasis of 0.31 for African Americans, 0.73 for Hispanics, and 1.42 for Asians, there was no statistical difference in metastasis, or death from uveal melanoma based on race.…”

Section: Introductionmentioning

confidence: 92%

“…[3][4][5][6][7][8][9][10] We have previously reviewed our 40-year experience with uveal melanoma in over 8000 patients relative to patient age at presentation, clinical features, tumor size, presence of melanocytosis, and classification. [10][11][12][13] Herein, we explore this large cohort for the prevalence and outcomes of uveal melanoma based on patient race.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prognosis of uveal melanoma based on race in 8100 patients: The 2015 Doyne Lecture

Shields

Kaliki

Cohen

et al. 2015

Eye

105

108

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A retrospective, nonrandomized, interventional case series of 8100 patients with uveal melanoma were evaluated for melanoma-related metastasis based on patient race. The patient race was Caucasian (n = 7918, 98%), Hispanic (n = 105, 1%), Asian (n = 44, o1%), or African American (n = 33, o1%). On the basis of race (Caucasian, Hispanic, Asian, and African American), significant differences were noted in mean age at presentation (58, 48, 44, and 52 years; Po0.001), distance of posterior tumor margin to foveola (5, 5, 6, and 4 mm; Po0.001), distance of posterior tumor margin to optic disc (5, 5, 6, and 4 mm) (Po0.001), tumor base (11, 12, 12, and 13 mm; Po0.001), tumor thickness (5.4, 7.1, 6.5, and 7.5 mm; Po0.001), intraocular hemorrhage (10, 14, 11, and 24%; P = 0.02), and rupture of Bruch's membrane (20, 27, 39, and 36%; P = 0.001). On the basis of multivariate analysis, the rate of metastasis increased with increasing age (Po0.001), ciliary body location (Po0.001), increasing tumor base (Po0.001), increasing tumor thickness (Po0.001), pigmented tumor (P = 0.001), subretinal fluid (P = 0.001), intraocular hemorrhage (P = 0.045), and extraocular extension (P = 0.036). KaplanMeier estimates of metastasis at 3, 5, and 10 were 8,15, and 25% in Caucasians;13,13, and 13% in Hispanics;4,4, and 36% in Asians;and 8,8, and 8% in African Americans. Compared with Caucasians, despite relative risk for metastasis of 0.31 for African Americans, 0.73 for Hispanics, and 1.42 for Asians, there was no statistical difference in metastasis, or death from uveal melanoma based on race. In summary, uveal melanoma showed similar prognosis for all races.

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Section: Introductionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Prognosis of uveal melanoma based on race in 8100 patients: The 2015 Doyne Lecture

Shields

Kaliki

Cohen

et al. 2015

Eye

105

108

View full text Add to dashboard Cite

show abstract

“…Tumors in each category can be further subclassified on the basis of the presence or absence of ciliary body involvement and extraocular extension (EOE) [71].…”

Section: Diagnosis and Prognosis Of Uveal Melanomamentioning

confidence: 99%

Uveal Melanoma: A Review of the Literature

2018

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Melanomas affecting different components of the uvea occur with differing frequencies and clinical presentations. Uveal melanoma is diagnosed via funduscopic exam and ancillary tests. These lesions may present with visual findings or incidental findings on physical exam. Metastasis occurs in approximately half of all patients with primary uveal melanoma. The liver is the most common site of metastasis. Enucleation was at one time considered the definitive local treatment for primary uveal melanoma, but has been largely replaced by other therapeutic procedures that aim to prevent metastasis while preserving vision. Unfortunately, metastasis of uveal melanoma almost always proves to be fatal. The current treatment of metastatic uveal melanoma is limited by the intrinsic resistance of uveal melanoma to conventional systemic therapies. Advancements in molecular biology have resulted in the identification of a number of promising prognostic and therapeutic targets. Early detection and therapy are important factors in disease survival. It is imperative that the treating physician be familiar with the clinical features of uveal melanoma and distinguish it from mimickers in order to ensure effective and timely treatment.

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“…Both extrascleral tumor extension and post-irradiation tumor recurrence are associated with an increased risk of metastasis and death [9,10,11]. Furthermore, the presence of extrascleral extension is associated with an increased risk of local orbital recurrence following enucleation (HR = 3.2; 95% CI: 1.5-6.7; p = 0.003) [11].…”

Section: Discussionmentioning

confidence: 99%

Extrascleral Tumor Extension Associated with Localized Scleral Melt following Plaque Brachytherapy for Uveal Melanoma: Clinical and Histologic Findings

2017

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Background/Aims: Our study aims to better characterize the clinical and histopathologic features of eyes with extrascleral uveal melanoma associated with scleral melt following brachytherapy. Methods: A retrospective review was performed on patients who had undergone ¹²⁵I (iodine-125) brachytherapy for uveal melanoma at our institution between 1992 and 2015. Patients with postradiation scleral necrosis who required enucleation were identified, and an analysis including a review of histopathology results was performed on those cases. Results: A total of 301 patients underwent plaque brachytherapy for uveal melanoma, of whom 31 required eventual enucleation. The histologic analysis showed extraocular extension through full-thickness scleral discontinuities in 6 cases. All but 1 (5 of 6) of these eyes exhibited either mitotic figures or Ki-67 positivity. Mitotic figures were noted in 4 specimens, including 3 eyes exhibiting mitoses within or adjacent to the extrascleral portion of the tumor. Two eyes exhibiting mitoses, as well as the case with Ki-67 positivity, also had clinical evidence of tumor regrowth. Conclusion: We found evidence of mitotic activity at the area of scleral discontinuity in some eyes with and in some without clinical evidence of tumor regrowth. Protruding pigmented material in areas of scleral necrosis after plaque brachytherapy may represent actively proliferating tumors even without internal evidence of tumor regrowth.

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American Joint Committee on Cancer Classification of Posterior Uveal Melanoma (Tumor Size Category) Predicts Prognosis in 7731 Patients

Cited by 121 publications

References 16 publications

Prognosis of uveal melanoma based on race in 8100 patients: The 2015 Doyne Lecture

Prognosis of uveal melanoma based on race in 8100 patients: The 2015 Doyne Lecture

Uveal Melanoma: A Review of the Literature

Extrascleral Tumor Extension Associated with Localized Scleral Melt following Plaque Brachytherapy for Uveal Melanoma: Clinical and Histologic Findings

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