Impact of Delayed Treatment in Growing Posterior Uveal Melanomas

Estimating Cured Fractions of Uveal Melanoma

“…Damato and Afshar and Damato have explored hypothetical scenarios with varying assumptions regarding natural history and possible survival benefit of ocular therapy . Augsburger et al postulated that the ocular therapy had no effect on risk of metastasis in bad prognostic cases because metastasis had already happened and was not going to happen in those with good prognosis. Our analysis supports the position that high-risk patients are being undertreated and suggests consideration of adjuvant therapy in such patients …”

Estimating Cured Fractions of Uveal Melanoma

“…Damato and Afshar and Damato have explored hypothetical scenarios with varying assumptions regarding natural history and possible survival benefit of ocular therapy . Augsburger et al postulated that the ocular therapy had no effect on risk of metastasis in bad prognostic cases because metastasis had already happened and was not going to happen in those with good prognosis. Our analysis supports the position that high-risk patients are being undertreated and suggests consideration of adjuvant therapy in such patients …”

No differences in the long-term prognosis of iris and choroidal melanomas when adjusting for tumor thickness and diameter

“…This may be a utopia for choroidal and ciliary body melanomas that are often asymptomatic until they have become medium-sized or even large but is perfectly illustrated by iris melanomas: They are treated when they are small, and metastatic rates are low. This conclusion may be supported by previous indications of increased mortality among patients who chose to defer or receive no treatment, whereas it is contradicted by other studies that have found no increased mortality when treatment is delayed [ 34 , 35 ].…”

Uveal melanoma: updated considerations on current management modalities

“…It is therefore more likely that differences in survival rates after any given form of treatment will reflect the selection criteria for patients subjected to that specific form of treatment. The validity of this postulate is supported by the agreement in all reports, that within the first 8-10 years no significant difference in survival rate has ever been noted when various treatment modalities are compared [17][18][19][20][21] or when survival in 'promptly treated patients' is compared with those in whom 'treatment has been delayed' [22]. Therefore, the essential requirements for valid statistical comparisons are: -a 10-15 year survival rate of all treated patients, and -accurate assessment of visual function in all living patients after a 5-year or more follow-up, without any selection bias.…”

Estimating Cured Fractions of Uveal Melanoma

“…Damato and Afshar and Damato have explored hypothetical scenarios with varying assumptions regarding natural history and possible survival benefit of ocular therapy . Augsburger et al postulated that the ocular therapy had no effect on risk of metastasis in bad prognostic cases because metastasis had already happened and was not going to happen in those with good prognosis. Our analysis supports the position that high-risk patients are being undertreated and suggests consideration of adjuvant therapy in such patients …”

No differences in the long-term prognosis of iris and choroidal melanomas when adjusting for tumor thickness and diameter

“…This may be a utopia for choroidal and ciliary body melanomas that are often asymptomatic until they have become medium-sized or even large but is perfectly illustrated by iris melanomas: They are treated when they are small, and metastatic rates are low. This conclusion may be supported by previous indications of increased mortality among patients who chose to defer or receive no treatment, whereas it is contradicted by other studies that have found no increased mortality when treatment is delayed [ 34 , 35 ].…”

Uveal melanoma: updated considerations on current management modalities

“…It is therefore more likely that differences in survival rates after any given form of treatment will reflect the selection criteria for patients subjected to that specific form of treatment. The validity of this postulate is supported by the agreement in all reports, that within the first 8-10 years no significant difference in survival rate has ever been noted when various treatment modalities are compared [17][18][19][20][21] or when survival in 'promptly treated patients' is compared with those in whom 'treatment has been delayed' [22]. Therefore, the essential requirements for valid statistical comparisons are: -a 10-15 year survival rate of all treated patients, and -accurate assessment of visual function in all living patients after a 5-year or more follow-up, without any selection bias.…”

Estimating Cured Fractions of Uveal Melanoma

“…Damato and Afshar and Damato have explored hypothetical scenarios with varying assumptions regarding natural history and possible survival benefit of ocular therapy . Augsburger et al postulated that the ocular therapy had no effect on risk of metastasis in bad prognostic cases because metastasis had already happened and was not going to happen in those with good prognosis. Our analysis supports the position that high-risk patients are being undertreated and suggests consideration of adjuvant therapy in such patients …”

No differences in the long-term prognosis of iris and choroidal melanomas when adjusting for tumor thickness and diameter

“…This may be a utopia for choroidal and ciliary body melanomas that are often asymptomatic until they have become medium-sized or even large but is perfectly illustrated by iris melanomas: They are treated when they are small, and metastatic rates are low. This conclusion may be supported by previous indications of increased mortality among patients who chose to defer or receive no treatment, whereas it is contradicted by other studies that have found no increased mortality when treatment is delayed [ 34 , 35 ].…”

Uveal melanoma: updated considerations on current management modalities

“…It is therefore more likely that differences in survival rates after any given form of treatment will reflect the selection criteria for patients subjected to that specific form of treatment. The validity of this postulate is supported by the agreement in all reports, that within the first 8-10 years no significant difference in survival rate has ever been noted when various treatment modalities are compared [17][18][19][20][21] or when survival in 'promptly treated patients' is compared with those in whom 'treatment has been delayed' [22]. Therefore, the essential requirements for valid statistical comparisons are: -a 10-15 year survival rate of all treated patients, and -accurate assessment of visual function in all living patients after a 5-year or more follow-up, without any selection bias.…”