Patients presenting with metastases: stage IV uveal melanoma, an international study.
Iris
choroid
ciliary body
imaging
retina
Journal
The British journal of ophthalmology
ISSN: 1468-2079
Titre abrégé: Br J Ophthalmol
Pays: England
ID NLM: 0421041
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
received:
11
09
2020
revised:
17
11
2020
accepted:
19
11
2020
pubmed:
17
1
2021
medline:
15
4
2022
entrez:
16
1
2021
Statut:
ppublish
Résumé
To analyse ocular and systemic findings of patients presenting with systemic metastasis. It is an international, multicentre, internet-enabled, registry-based retrospective data analysis. Patients were diagnosed between 2001 and 2011. Data included: primary tumour dimensions, extrascleral extension, ciliary body involvement, American Joint Committee on Cancer (AJCC)-tumour, node, metastasis staging, characteristics of metastases. Of 3610 patients with uveal melanoma, 69 (1.9%; 95% CI 1.5 to 2.4) presented with clinical metastasis (stage IV). These melanomas originated in the iris, ciliary body and choroid in 4%, 16% and 80% of eyes, respectively. Using eighth edition AJCC, 8 (11%), 20 (29%), 24 (35%), and 17 (25%) belonged to AJCC T-categories T1-T4. Risk of synchronous metastases increased from 0.7% (T1) to 1.5% (T2), 2.6% (T3) and 7.9% (T4). Regional lymph node metastases (N1a) were detected in 9 (13%) patients of whom 6 (67%) had extrascleral extension. Stage of systemic metastases (known for 40 (59%) stage IV patients) revealed 14 (35%), 25 (63%) and 1 (2%) had small (M1a), medium-sized (M1b) and large-sized (M1c) metastases, respectively. Location of metastases in stage IV patients were liver (91%), lung (16%), bone (9%), brain (6%), subcutaneous tissue (4%) and others (5%). Multiple sites of metastases were noted in 24%. Compared with the 98.1% of patients who did not present with metastases, those with synchronous metastases had larger intraocular tumours, more frequent extrascleral extension, ciliary body involvement and thus a higher AJCC T-category. Though higher AJCC T-stage was associated with risk for metastases at diagnosis, even small T1 tumours were stage IV at initial presentation. The liver was the most common site of metastases; however, frequent multiorgan involvement supports initial whole-body staging.
Identifiants
pubmed: 33452185
pii: bjophthalmol-2020-317949
doi: 10.1136/bjophthalmol-2020-317949
pmc: PMC8961763
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
510-517Investigateurs
Paul T Finger
(PT)
Sarah E Coupland
(SE)
Daniel M Albert
(DM)
Anush G Amiryan
(AG)
Svetlana Saakyan
(S)
Claudia Auw-Hädrich
(C)
Diane Baker
(D)
Raymond Barnhill
(R)
José M Caminal
(JM)
William L Caroll
(WL)
Nathalie Cassoux
(N)
Laurence G Desjardins
(LG)
Gaelle Pierron
(G)
Jaume Catalá-Mora
(J)
Guillermo Chantada
(G)
Patricia Chévez-Barrios
(P)
R Max Conway
(R)
Bertil E Damato
(BE)
Hakan Demirci
(H)
Jonathan J Dutton
(JJ)
Bita Esmaeli
(B)
Victor G Prieto
(VG)
Michelle Williams
(M)
Brenda L Gallie
(BL)
Gerardo F Graue
(GF)
Hans E Grossniklaus
(HE)
Steffen Heegaard
(S)
Leonard M Holbach
(LM)
Santosh G Honavar
(SG)
Martine J Jager
(MJ)
Tero T Kivelä
(TT)
Emma Kujala
(E)
Livia Lumbroso-Le Rouic
(LL)
Ashwin C Mallipatna
(AC)
Giulio M Modorati
(GM)
Francis L Munier
(FL)
Timothy G Murray
(TG)
Anna C Pavlick
(AC)
Jacob Pe'er
(J)
David E Pelayes
(DE)
Manuel Rodrigues
(M)
Wolfgang A G Sauerwein
(WAG)
Ekaterina Semenova
(E)
Stefan Seregard
(S)
Carol Shields
(C)
E Rand Simpson
(E)
Arun D Singh
(AD)
Shigenobu Suzuki
(S)
Mary Kay Washington
(MK)
Valerie A White
(VA)
Mathew W Wilson
(MW)
Christian W Wittekind
(CW)
Vivian Yin
(V)
Informations de copyright
© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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