Clinical Spectrum and Prognosis of Uveal Melanoma Based on Age at Presentation in 8,033 Cases

Shields, Carol L.; Kaliki, Swathi; Furuta, Minoru; Mashayekhi, Arman; Shields, Jerry A.

doi:10.1097/iae.0b013e31824d09a8

Cited by 259 publications

(252 citation statements)

References 20 publications

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“…There have been a few studies to assess features and prognosis of uveal melanoma in non-Caucasians. [3][4][5][6][7][8][9][10] Margo et al 5 evaluated enucleated eyes with uveal melanoma in the Florida Cancer Data System between 1981 and 1993, stratified by race, and noted 814 (94%) Caucasians, 47 (5%) Hispanics, and 4 (o1%) African Americans. They observed that Caucasian men had a 72-fold greater risk for uveal melanoma compared to African American men and Caucasian women had 22-fold risk compared with African American women.…”

Section: Discussionmentioning

confidence: 99%

“…[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

111

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: Discussionmentioning

confidence: 99%

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

111

108

View full text Add to dashboard Cite

show abstract

“…Tumor epicenters are usually found in the choroid, but may also arise from the iris and ciliary body. About 45% of uveal melanoma cases were recorded in adults older than 60 years and 53% were in adults ages between 21 and 60 years old (1). The 5-year survival rate of uveal melanoma patients from 1973 to 2008 is 81.6% (2).…”

Section: Introductionmentioning

confidence: 99%

Crizotinib, a c-Met Inhibitor, Prevents Metastasis in a Metastatic Uveal Melanoma Model

Surriga

Rajasekhar

Ambrosini

et al. 2013

Molecular Cancer Therapeutics

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Uveal melanoma is the most common primary intraocular malignant tumor in adults and half of the primary tumors will develop fatal metastatic disease to the liver and the lung. Crizotinib, an inhibitor of c-Met, anaplastic lymphoma kinase (ALK), and ROS1, inhibited the phosphorylation of the c-Met receptor but not of ALK or ROS1 in uveal melanoma cells and tumor tissue. Consequently, migration of uveal melanoma cells was suppressed in vitro at a concentration associated with the specific inhibition of c-Met phosphorylation. This effect on cell migration could be recapitulated with siRNA specific to c-Met but not to ALK or ROS1. Therefore, we developed a uveal melanoma metastatic mouse model with EGFPluciferase-labeled uveal melanoma cells transplanted by retro-orbital injections to test the effect of crizotinib on metastasis. In this model, there was development of melanoma within the eye and also metastases to the liver and lung at 7 weeks after the initial transplantation. When mice were treated with crizotinib starting 1 week after the transplantation, we observed a significant reduction in the development of metastases as compared with untreated control sets. These results indicate that the inhibition of c-Met activity alone may be sufficient to strongly inhibit metastasis of uveal melanoma from forming, suggesting crizotinib as a potential adjuvant therapy for patients with primary uveal melanoma who are at high risk for the development of metastatic disease.

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“…The average age of initial diagnosis of uveal melanoma is approximately 60 years [7,12]. Compared with older patients, younger patients are more likely to present with iris melanomas, have associated melanocytosis, and a lower risk of metastatic disease [13]. Pediatric and congenital cases have been reported, but seldom occur [2,14].…”

Section: Epidemiologymentioning

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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Clinical Spectrum and Prognosis of Uveal Melanoma Based on Age at Presentation in 8,033 Cases

Abstract: Compared with mid adults and older adults, young patients manifested a higher proportion of iris melanoma. Compared with older adults, young and mid adults showed smaller melanoma basal dimension and lower tumor-related metastasis and death.

Cited by 259 publications

References 20 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

Crizotinib, a c-Met Inhibitor, Prevents Metastasis in a Metastatic Uveal Melanoma Model

Uveal Melanoma: A Review of the Literature

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