Adjuvant External Beam Radiotherapy Following Enucleation of Eyes With Extraocular Extension From Uveal Melanoma.
Journal
Ophthalmic plastic and reconstructive surgery
ISSN: 1537-2677
Titre abrégé: Ophthalmic Plast Reconstr Surg
Pays: United States
ID NLM: 8508431
Informations de publication
Date de publication:
Historique:
pubmed:
4
10
2020
medline:
25
5
2021
entrez:
3
10
2020
Statut:
ppublish
Résumé
To report local disease control and all-cause mortality in patients with extraocular extension (EOE) of uveal melanoma undergoing enucleation followed by observation or external beam radiotherapy (EBRT). Charts of patients enucleated between January 1, 1997 and December 31, 2019, with histopathological evidence of EOE of uveal melanoma were reviewed. The cohort comprised 51 patients with a mean age of 67 ± 15 years, 22 (43%) of whom underwent adjuvant postenucleation EBRT. Risk factors for metastasis included presence of epithelioid cells (29/45; 88%), closed loops (20/43; 47%), monosomy 3 (16/25; 64%), and gain of 8q (20/22; 91%). Patients undergoing EBRT had more extensive EOE (median: 5.1 mm vs. 2.6 mm, p = 0.008) and surgical excision was less likely to be histologically complete (2/20; 10% vs. 14/25; 56%, p = 0.002). Local side effects following EBRT were seen in 64% (14/22). At latest follow up, 59% of patients (30/51) were alive, with a median follow up of 1.8 years (interquartile range: 2.9; range: 0.1-6.5]. By Kaplan-Meier survival analysis, the 5- and 10-year overall survival rates were 56% and 12%, respectively. There was no difference in all-cause mortality between those receiving adjuvant EBRT and those who were observed (log rank, p = 0.273). No cases of orbital recurrence were documented. Orbital EBRT causes significant morbidity. Cases with relatively small EOE undergoing enucleation can be safely observed, without adjuvant EBRT. Multicenter studies are required to better assess the role of EBRT when EOE is more extensive.
Identifiants
pubmed: 33009323
pii: 00002341-202105001-00011
doi: 10.1097/IOP.0000000000001800
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
S48-S53Informations de copyright
Copyright © 2021 The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc.
Déclaration de conflit d'intérêts
The authors have no financial or conflicts of interest to disclose.
Références
Avery RB, Diener-West M, Reynolds SM, et al. Histopathologic characteristics of choroidal melanoma in eyes enucleated after iodine 125 brachytherapy in the collaborative ocular melanoma study Arch Ophthalmol. 2008; 126:207–212
Shields CL, Furuta M, Thangappan A, et al. Metastasis of uveal melanoma millimeter-by-millimeter in 8033 consecutive eyes Arch Ophthalmol. 2009; 127:989–998
Bellmann C, Lumbroso-Le Rouic L, Levy C, et al. Uveal melanoma: management and outcome of patients with extraocular spread Br J Ophthalmol. 2010; 94:569–574
Shields CL, Kaliki S, Furuta M, et al. American Joint Committee on Cancer Classification of uveal melanoma (anatomic stage) predicts prognosis in 7,731 patients: the 2013 Zimmerman lecture Ophthalmology. 2015; 122:1180–1186
Affeldt JC, Minckler DS, Azen SP, et al. Prognosis in uveal melanoma with extrascleral extension Arch Ophthalmol. 1980; 98:1975–1979
Coupland SE, Campbell I, Damato B.Routes of extraocular extension of uveal melanoma: risk factors and influence on survival probability Ophthalmology. 2008; 115:1778–1785
van Beek JG, Koopmans AE, Vaarwater J, et al. The prognostic value of extraocular extension in relation to monosomy 3 and gain of chromosome 8q in uveal melanoma Invest Ophthalmol Vis Sci. 2014; 55:1284–1291
Kujala E, Damato B, Coupland SE, et al. Staging of ciliary body and choroidal melanomas based on anatomic extent J Clin Oncol. 2013; 31:2825–2831
Hogan M.Clinical aspects, management and prognosis of melanomas of the uvea and optic nerve. In: Boniuk M, ed. Ocular and Adnexal Tumors, New and Controversial Aspects. St. Louis, MO: Mosby, 1964;280
Shammas HF, Blodi FC.Orbital extension of choroidal and ciliary body melanomas Arch Ophthalmol. 1977; 95:2002–2005
Kersten RC, Tse DT, Anderson RL, et al. The role of orbital exenteration in choroidal melanoma with extrascleral extension Ophthalmology. 1985; 92:436–443
Hykin PG, McCartney AC, Plowman PN, et al. Postenucleation orbital radiotherapy for the treatment of malignant melanoma of the choroid with extrascleral extension Br J Ophthalmol. 1990; 74:36–39
Nasser QJ, Gombos DS, Williams MD, et al. Management of radiation-induced severe anophthalmic socket contracture in patients with uveal melanoma Ophthalmic Plast Reconstr Surg. 2012; 28:208–212
Finger PT, Tena LB, Semenova E, et al. Extrascleral extension of choroidal melanoma: post-enucleation high-dose-rate interstitial brachytherapy of the orbit Brachytherapy. 2014; 13:275–280
Burris CKH, Papastefanou VP, Thaung C, et al. Detection of extrascleral extension in uveal melanoma with histopathological correlation Orbit. 2018; 37:287–292
Dogrusöz M, Kroes WG, van Duinen SG, et al. Radiation treatment affects chromosome testing in uveal melanoma Invest Ophthalmol Vis Sci. 2015; 56:5956–5964
Pach JM, Robertson DM, Taney BS, et al. Prognostic factors in choroidal and ciliary body melanomas with extrascleral extension Am J Ophthalmol. 1986; 101:325–331
Jensen OA.Malignant melanomas of the human uvea: 25-year follow-up of cases in Denmark, 1943–1952 Acta Ophthalmol (Copenh). 1982; 60:161–182
Hanley JA, Lippman-Hand A.If nothing goes wrong, is everything all right? Interpreting zero numerators JAMA. 1983; 249:1743–1745
Rose AM, Cowen S, Jayasena CN, et al. Presentation, treatment, and prognosis of secondary melanoma within the orbit Front Oncol. 2017; 7:125
Shields JA, Augsburger JJ, Dougherty MJ.Orbital recurrence of choroidal melanoma 20 years after enucleation Am J Ophthalmol. 1984; 97:767–770
Russo A, Rene C, Coupland SE, et al. Discrepancy between fluorescence in situ hybridization and multiplex ligation-dependent probe amplification in orbital recurrence of uveal melanoma 26 years after enucleation Ophthalmic Plast Reconstr Surg. 2012; 28:e140–e142
Allen JC, Jaeschke WH.Recurrence of malignant melanoma in an orbit after 28 years Arch Ophthalmol. 1966; 76:79–81
Shields JA, Augsburger JJ, Donoso LA, et al. Hepatic metastasis and orbital recurrence of uveal melanoma after 42 years Am J Ophthalmol. 1985; 100:666–668
Francis JH, Barker CA, Yin VT, et al. Chemoreduction of orbital recurrence of uveal melanoma by intra-arterial melphalan Ocul Oncol Pathol. 2019; 5:186–189
The Collaborative Ocular Melanoma Study (COMS) randomized trial of pre-enucleation radiation of large choroidal melanoma II: initial mortality findings. COMS report no. 10 Am J Ophthalmol. 1998; 125:779–796
Hawkins BS; Collaborative Ocular Melanoma Study Group. The Collaborative Ocular Melanoma Study (COMS) randomized trial of pre-enucleation radiation of large choroidal melanoma: IV. Ten-year mortality findings and prognostic factors. COMS report number 24. Am J Ophthalmol. 2004; 138:936–951
Lederman M.Radiotherapy in the treatment of orbital tumours Br J Ophthalmol. 1956; 40:592–610
Kivelä T, Simpson E, Grossniklaus H.. Uveal Melanoma. 8th ed. New York, NY: Springer, 2017
Kidd MN, Lyness RW, Patterson CC, et al.Prognostic factors in malignant melanoma of the choroid: a retrospective survey of cases occurring in Northern Ireland between 1965 and 1980 Trans Ophthalmol Soc U K. 1986; 105Pt 1114–121
Shields JA, Shields CL.Massive orbital extension of posterior uveal melanomas Ophthalmic Plast Reconstr Surg. 1991; 7:238–251
Ross JJ, Dean SJ, Koppel DA, et al. Massive orbital recurrence of uveal melanoma without metastases after 28 years Br J Ophthalmol. 2010; 94:632
Shields CL, Shields JA, Yarian DL, et al. Intracranial extension of choroidal melanoma via the optic nerve Br J Ophthalmol. 1987; 71:172–176
Seibel I, Riechardt AI, Erb-Eigner K, et al. Proton beam irradiation: a safe procedure in postequatorial extraocular extension from uveal melanoma Am J Ophthalmol. 2018; 191:49–53
Weissgold DJ, Gragoudas ES, Green JP, et al. Eye-sparing treatment of massive extrascleral extension of choroidal melanoma Arch Ophthalmol. 1998; 116:531–533
Augsburger JJ, Schneider S, Narayana A, et al. Plaque radiotherapy for choroidal and ciliochoroidal melanomas with limited nodular extrascleral extension Can J Ophthalmol. 2004; 39:380–387
Semenova E, Finger PT.Palladium-103 plaque radiation therapy for American Joint Committee on cancer T3- and T4-staged choroidal melanomas JAMA Ophthalmol. 2014; 132:205–213
George S, Cooke CA, Mc Ginnity GF, et al. Treated choroidal melanoma with late metastases to the contralateral orbit Clin Med Pathol. 2009; 2:5–8
Böhm MR, Tsianakas A, Merté RL, et al. Mutational analysis of GNAQ and GNA11 to aid therapy management of a choroidal melanoma metastatic to the contralateral orbit JAMA Ophthalmol. 2013; 131:812–814
McElnea E, Stevenson LJ, La Rosa CS, et al. Choroidal melanoma metastatic to the contralateral medial rectus after orbital exenteration Turk J Ophthalmol. 2019; 49:305–309