Prognostic Factors in Choroidal and Ciliary Body Melanomas

Shammas, Hanna F.; Blodi, Frederick C.

doi:10.1001/archopht.1977.04450010065005

Cited by 263 publications

(82 citation statements)

References 6 publications

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“…Follow-up was attempted in every case but was not available for those 218 patients. Furthermore, 42 eyes were promptly enucleated following the initial visit. These 42 patients and their clinical parameters were included in our evaluation for metastasis.…”

Section: Discussionmentioning

confidence: 43%

Risk Factors for Growth and Metastasis of Small Choroidal Melanocytic Lesions

et al. 1995

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Section: Discussionmentioning

confidence: 43%

Risk Factors for Growth and Metastasis of Small Choroidal Melanocytic Lesions

et al. 1995

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“…Many malignant tumours spread via the bloodstream and, while the number of such cells thought to be present is relatively small, it is these cells that will be a major factor in determining the patients' final outcome. The detection of such cells is potentially important, both clinically, as presumably their presence would be an adverse prognostic factor, and scientifically, as it would allow the isolation, and subsequent study, of such cells by fractionation procedures.Early attempts used microscopy to examine the cells retained on 'sieves' after filtration of blood samples (Goldblatt and Nadel, 1965;McGrew, 1965;Seal, 1964;Stanford, 1971 (McLean et al, 1977(McLean et al, , 1982Shammas and Blodi, 1977) despite the fact that only 1% of patients show evidence of metastases at presentation (Char, 1978). Fraunfelder et al (1977) suggested that surgery could provoke metastatic spread, and this was followed by the proposal that two-thirds of metastatic disease is attributable to surgical manipulation of the globe during enucleation for uveal melanoma (Zimmerman et al, 1978; 7immerman and McLean, 1979;McLean et al, 1982 …”

mentioning

confidence: 43%

“…Early attempts used microscopy to examine the cells retained on 'sieves' after filtration of blood samples (Goldblatt and Nadel, 1965;McGrew, 1965;Seal, 1964;Stanford, 1971 (McLean et al, 1977(McLean et al, , 1982Shammas and Blodi, 1977) despite the fact that only 1% of patients show evidence of metastases at presentation (Char, 1978). Fraunfelder et al (1977) suggested that surgery could provoke metastatic spread, and this was followed by the proposal that two-thirds of metastatic disease is attributable to surgical manipulation of the globe during enucleation for uveal melanoma (Zimmerman et al, 1978; 7immerman and McLean, 1979;McLean et al, 1982 …”

mentioning

confidence: 43%

The detection of melanoma cells in peripheral blood by reverse transcription-polymerase chain reaction

Foss¹,

Guille²,

Occleston³

et al. 1995

Br J Cancer

147

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Dxr)u Lane, London WC2B 5RL; 3Department of Ocular Oncology, Moorfield's Eye Hospital, City Road, London ECJ V 2PD, UK.Summry Both cutaneous and uveal melanoma undergo haematogenous dissemination. Detection of tyrosinase mRNA by reverse transcription-polymerase chain reaction (RT-PCR) has been described as an extremely sensitive way of detecting circulating viable melanoma cells in the penrpheral venous blood, and this technique may be of value in the early detection of dissemination. Also, it has been suggested that surgical manipulation of the eye, such as occurs during enucleation, can provoke uveal melanoma dissemination. The purpose of this study was to evaluate whether tyrosinase mRNA is detectable in the peripheral blood of patients with uveal and cutaneous melanoma and in patients with uveal melanoma undergoing surgical procedures on the eye harbouring the tumour. Venous blood samples from 36 patients diagnosed as having active uveal melanoma and from six patients with advanced metastatic cutaneous melanoma were analysed. In addition, blood samples were spiked with known numbers of cells from three cell lines and four primary uveal melanoma cultures. The reported sensitivity of the technique was confirmed, with an ability to detect down to one cell per ml of blood. All 51 blood samples from the 36 patients with uveal melanoma were negative, and this included 20 perioperative blood samples. The test was also negative for the six patients with advanced cutaneous melanoma. There were two positives among 31 control samples analysed. This study demonstrates that there are far fewer circulating viable melanocytes than has been previously supposed in patients with melanoma and that the RT-PCR is of no clinical value in detecting metastatic melanoma disease. There was no evidence for surgery causing a bolus of melanoma cells to enter the peripheral circulation.Keywords melanoma; metastasis; polymerase chain reaction; tyrosinase; uvea There have been many attempts to detect circulating cells from solid malignant tumours in peripheral blood. Many malignant tumours spread via the bloodstream and, while the number of such cells thought to be present is relatively small, it is these cells that will be a major factor in determining the patients' final outcome. The detection of such cells is potentially important, both clinically, as presumably their presence would be an adverse prognostic factor, and scientifically, as it would allow the isolation, and subsequent study, of such cells by fractionation procedures.Early attempts used microscopy to examine the cells retained on 'sieves' after filtration of blood samples (Goldblatt and Nadel, 1965;McGrew, 1965;Seal, 1964;Stanford, 1971 (McLean et al., 1977(McLean et al., , 1982Shammas and Blodi, 1977) despite the fact that only 1% of patients show evidence of metastases at presentation (Char, 1978). Fraunfelder et al. (1977) suggested that surgery could provoke metastatic spread, and this was followed by the proposal that two-thirds of metastatic disease is attributable t...

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“…2,9,18,22,23 Several studies have shown that the size of the uveal melanoma is a risk factor for subsequent metastases. 22,24,25 In the multivariate analyses, we found that large basal tumour diameter was the only significant predictive factor for metastatic disease. The differences in tumour size could therefore explain the difference between the mortality curves in the two treatment groups.…”

Section: Discussionmentioning

confidence: 82%

Posterior uveal melanoma treated with I-125 brachytherapy or primary enucleation

Krohn

Monge

Skorpen

et al. 2007

Eye

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Purpose To study the incidence, clinical findings, and tumour characteristics of posterior uveal melanoma in Western Norway, and to report the results of a consistent treatment strategy (I-125 brachytherapy or primary enucleation) over a 13-year period. Methods The clinical records of all patients with posterior uveal melanoma referred between January 1993 and December 2005 were reviewed. Clinical data, radiation parameters, visual outcome, and mortality were analysed in a dedicated database. Results The study included 111 consecutive patients. The annual age-adjusted incidence (per million population) of posterior uveal melanoma was 8.5 for women and 8.9 for men. Fifty-six patients underwent I-125 brachytherapy, 52 were enucleated, and three received no treatment. The median follow-up time was 36 months (mean, 52 months; range, 2 months to 13 years). In the brachytherapy group, two eyes were enucleated owing to tumour recurrence and two because of neovascular glaucoma. A visual acuity of 0.1 or better, present in 87% of the patients before brachytherapy, was retained in 40% after a median follow-up of 61 months. After brachytherapy, the 5-and 10-year melanomaspecific mortality rates were 13.4 and 23.8%, respectively. The corresponding mortality rates for patients treated with primary enucleation were 49.5 and 49.5%. Conclusion After brachytherapy, many patients lost useful vision due to radiationinduced complications. The probability of retaining the eye was high and only two patients experienced recurrent tumour growth. The mortality rates compare well with published series, and the differences in tumour size explain the difference in mortality between the two treatment groups.

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Prognostic Factors in Choroidal and Ciliary Body Melanomas

Cited by 263 publications

References 6 publications

Risk Factors for Growth and Metastasis of Small Choroidal Melanocytic Lesions

Risk Factors for Growth and Metastasis of Small Choroidal Melanocytic Lesions

The detection of melanoma cells in peripheral blood by reverse transcription-polymerase chain reaction

Posterior uveal melanoma treated with I-125 brachytherapy or primary enucleation

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