J J Augsburger1, T R Vrabec. 1. Oncology Unit, Retina Service, Wills Eye Hospital-Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pa.
Abstract
OBJECTIVE: To investigate the impact of pretreatment tumor growth on survival in patients with primary posterior uveal melanoma. DESIGN: Retrospective case-by-case matched comparative survival study. PATIENTS: Thirty patients with documented tumor growth of at least 3 mm in basal diameter, 1.5 mm in thickness, or both during a pretreatment interval of 6 months or more and a matched control group of 30 promptly treated patients. Matching criteria included patient age (+/- 10 years), largest basal tumor diameter (+/- 2 mm), tumor thickness (+/- 1.5 mm), location of anterior tumor margin (same defined zone), and visual symptoms (present or absent). SETTING: The Oncology Unit of the Retina Service at Wills Eye Hospital, Philadelphia, Pa. INTERVENTIONS: All patients were treated in a nonrandomized fashion by conventional therapeutic methods appropriate to the tumor's size, location, and other factors. MAIN OUTCOME MEASURES: Actuarial melanoma-specific mortality and all-cause mortality. RESULTS: The mean +/- SE cumulative 5-year probability of melanoma-specific mortality relative to the date of initial examination was 17.1% +/- 7% in the delayed treatment group and 18.4% +/- 8% in the prompt treatment group. This difference is not statistically significant (P > .5, log rank test). CONCLUSIONS: These results lend support to the belief that delayed treatment of selected small and dormant-appearing choroidal and ciliary body melanomas does not substantially increase the probability of melanoma-specific mortality; however, they do not prove that observation is the correct management option for all patients with a posterior uveal melanoma.
OBJECTIVE: To investigate the impact of pretreatment tumor growth on survival in patients with primary posterior uveal melanoma. DESIGN: Retrospective case-by-case matched comparative survival study. PATIENTS: Thirty patients with documented tumor growth of at least 3 mm in basal diameter, 1.5 mm in thickness, or both during a pretreatment interval of 6 months or more and a matched control group of 30 promptly treated patients. Matching criteria included patient age (+/- 10 years), largest basal tumor diameter (+/- 2 mm), tumor thickness (+/- 1.5 mm), location of anterior tumor margin (same defined zone), and visual symptoms (present or absent). SETTING: The Oncology Unit of the Retina Service at Wills Eye Hospital, Philadelphia, Pa. INTERVENTIONS: All patients were treated in a nonrandomized fashion by conventional therapeutic methods appropriate to the tumor's size, location, and other factors. MAIN OUTCOME MEASURES: Actuarial melanoma-specific mortality and all-cause mortality. RESULTS: The mean +/- SE cumulative 5-year probability of melanoma-specific mortality relative to the date of initial examination was 17.1% +/- 7% in the delayed treatment group and 18.4% +/- 8% in the prompt treatment group. This difference is not statistically significant (P > .5, log rank test). CONCLUSIONS: These results lend support to the belief that delayed treatment of selected small and dormant-appearing choroidal and ciliary body melanomas does not substantially increase the probability of melanoma-specific mortality; however, they do not prove that observation is the correct management option for all patients with a posterior uveal melanoma.
Authors: E Weis; T G Salopek; J G McKinnon; M P Larocque; C Temple-Oberle; T Cheng; J McWhae; R Sloboda; M Shea-Budgell Journal: Curr Oncol Date: 2016-02-18 Impact factor: 3.677