Assessing Prognosis in Uveal Melanoma

Corrêa, Zélia M.

doi:10.1177/107327481602300202

Cited by 21 publications

(16 citation statements)

References 54 publications

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“…This supports the above‐mentioned findings of Barnhill et al in uveal melanoma, where angiotropism was found to be predictive of distant metastasis . Uveal melanoma typically metastasizes hematogenously, often to the liver, and the sclera lacks lymphatic channels. In our study, the association between angiotropism and distant metastasis was not significant in multivariate analysis ( P = 0.14).…”

Section: Discussionsupporting

confidence: 90%

Angiotropism in primary cutaneous melanoma is associated with disease progression and distant metastases: A retrospective study of 179 cases

et al. 2019

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Background: Angiotropism is the histopathological correlate of pericytic mimicry and extravascular migratory metastasis (EVMM), a mechanism of melanoma spread by migration along the external surface of blood and lymphatic vessels. The frequency of angiotropism in primary cutaneous melanoma and the clinical utility of its detection remain unclear.Methods: We investigated angiotropism in 179 primary cutaneous melanomas by hematoxylin and eosin (H&E), CD31, and S100/D240 stains.Results: We detected angiotropism in 31 cases (17%) by H&E. CD31 immunohistochemistry increased detection to 59 cases (33%). When lymphatic vessels were included by using S100/D240 stains, 67 cases (37%) cases were positive. Angiotropism was associated with lymphatic invasion and mitotic rate with all detection methods. There was an association with increased tumor thickness when detected by H&E and CD31. No association with sentinel lymph node status was seen. By H&E and CD31 staining, angiotropism was associated with disease progression and distant metastases by univariate, but not multivariate analysis. Overall survival was not affected by the presence of angiotropism.Conclusions: Angiotropism is relatively common in primary melanoma when immunohistochemical stains are used for detection and associated with mitotic rate and intravascular lymphatic invasion. The association with disease progression and distant metastasis suggests that it represents an alternative pathway of metastasis, that is, EVMM/pericytic mimicry vs intravascular spread. K E Y W O R D Sangiotropism, melanoma, metastasis, pericytic mimicry, survival

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Section: Discussionsupporting

confidence: 90%

Angiotropism in primary cutaneous melanoma is associated with disease progression and distant metastases: A retrospective study of 179 cases

et al. 2019

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“…Tumor heterogeneity may possibly account for the discordant test results [1,22,23,24,25]. Each biopsy sample was obtained by an independent needle pass.…”

Section: Discussionmentioning

confidence: 99%

“…Molecular prognostic biopsy for metastatic risk in the management of patients with uveal melanoma is standard of care at most major ophthalmic oncology practices in North America [1,2,3,4,5,6,7,8]. The loss of 1 copy of chromosome 3 (monosomy 3 [M3]) in the tumor tissue has been determined to be the risk factor most strongly associated with metastatic death originally reported in mostly large uveal melanoma [9,10,11].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Gene Expression Profiling and Chromosome 3 Analysis by Fluorescent in situ Hybridization and Multiplex Ligation Probe Amplification in Fine-Needle Aspiration Biopsy Specimens of Uveal Melanoma

et al. 2017

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Purpose: The aim of this paper was to assess the concordance between results of DecisionDx-UM specific gene expression profiling (GEP) and fluorescence in situ hybridization (FISH) for chromosome 3 analysis, and between DecisionDx-UM GEP and multiplex ligation probe amplification (MLPA) in uveal melanoma undergoing intraoperative fine-needle aspiration biopsy (FNAB) for metastatic prognostication during brachytherapy. Methods: We retrospectively reviewed consecutive patients diagnosed with posterior uveal melanoma who underwent intraoperative FNAB prior to placement of an iodine-125 radioactive plaque between 2012 and 2014. Two cohorts of patients were identified: Cohort 1 - tumors in which both GEP and FISH results were obtained, and Cohort 2 - tumors in which both GEP and MLPA results were obtained. Results: Forty-four patients were identified for Cohort 1. FISH and GEP results were discordant in 7 tumors (15.9%). Forty-three patients were identified for Cohort 2. MLPA and GEP were discordant in 7 tumors (16.3%). Conclusions: Discordance between GEP and chromosome 3 status by FISH and MLPA occurred in our series at a rate of 15.9 and 16.3%, respectively. Caution must be advised when counseling a patient with a good-prognosis GEP “Class 1” result that the uveal tumor may actually harbor monosomy 3, which is associated with a poor prognosis for metastasis in nearly 20% of the patients.

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“…8q gain is a poor prognosis factor (more frequently associated with metastases) [51], mainly when it occurs in the context of 8p loss, suggesting the formation of an isochromosome 8q [13]. This frequently occurs in tumors that have lost a copy of chromosome 3, and it is considered an independent prognostic factor of progressive disease [52]. Gain of chromosome 8 or obtainment of an isochromosome 8q may be a posterior occurrence in the setting of uveal melanoma, and is verified in both low-and high-risk uveal melanomas [53].…”

Section: Molecular Pathology Of Uveal Melanomamentioning

confidence: 99%

“…Taking into account gene expression profile (15-gene expression panel), uveal melanomas can be divided into two distinct prognostic classes, namely class 1 tumors (which generally have the clinical and pathological features known to be associated with decreased metastatic risk, such as the presence of spindle cells), and class 2 tumors (which generally have more aggressive clinical and pathological features, with a higher risk for metastases). This test is commercially available for routine use in clinical practice [13,52].…”

Section: Risk Factors Detection and Diagnosis Of Uveal Melanomamentioning

confidence: 99%

Uveal melanoma: physiopathology and new in situ-specific therapies

Souto

Zielińska

Luís

et al. 2019

Cancer Chemother Pharmacol

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Uveal melanoma is the most common primary intraocular tumor in adults. It can arise from melanocytes in the anterior (iris) or posterior uveal tract (choroid and ciliary body). Uveal melanoma has a particular molecular pathogenesis, being characterized by specific chromosome alterations and gene mutations (e.g., GNAQ/GNA11; BAP1), which are considered promising targets for molecular therapy. Primary treatment of uveal melanoma includes radiotherapy (brachytherapy and charged-particle therapy), phototherapy (photocoagulation, transpupillary thermal therapy, and photodynamic therapy) and surgery (local resection, enucleation and exenteration). Approximately half of patients with uveal melanoma will, however, develop metastasis, especially in the liver. The treatment of metastatic uveal melanoma includes systemic chemotherapy, immunotherapy and molecular targeted therapy. Liver-directed therapies, such as resection, chemoembolization, immunoembolization, radioembolization, isolated hepatic perfusion and percutaneous hepatic perfusion, are also available to treat metastatic uveal melanoma. Several clinical trials are being developed to study new therapeutic options to treat uveal melanoma, mainly for those with identified liver metastases. The present work discusses the physiopathology and new in situ-specific therapies for the treatment of uveal melanoma.

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Assessing Prognosis in Uveal Melanoma

Cited by 21 publications

References 54 publications

Angiotropism in primary cutaneous melanoma is associated with disease progression and distant metastases: A retrospective study of 179 cases

Angiotropism in primary cutaneous melanoma is associated with disease progression and distant metastases: A retrospective study of 179 cases

Comparison of Gene Expression Profiling and Chromosome 3 Analysis by Fluorescent in situ Hybridization and Multiplex Ligation Probe Amplification in Fine-Needle Aspiration Biopsy Specimens of Uveal Melanoma

Uveal melanoma: physiopathology and new in situ-specific therapies

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