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Mu SIC report III : tumour microcirculation patterns and development of metastasis in long‐term follow‐up of melanocytic uveal tumours
Author(s) -
Klingenstein Annemarie,
Schaumberger Markus M,
Freeman William R,
Folberg Robert,
Mueller Arthur J,
Schaller Ulrich C
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.12836
Subject(s) - medicine , malignancy , melanoma , choroid , pathology , microcirculation , metastasis , exact test , fundus (uterus) , radiology , cancer , retina , physics , cancer research , optics
Abstract Purpose To statistically determine differences in microcirculation patterns between nevi and uveal melanomas and the influence of these patterns on metastatic potential in the long‐term follow‐up of 112 patients with melanocytic uveal tumours. In vivo markers indicating malignancy and metastatic potential have implications for treatment decision. Methods Primary diagnosis and work‐up included clinical examination, fundus photography, standardized A and B scan echography as well as evaluation of tumour microcirculation patterns via confocal fluorescein and indocyanine green angiography ( ICGA ). Patient data were collected from the patient files, the tumour registry or personal contact. Statistical analysis was performed with spss 22.0 using chi‐square, Fisher's exact test and Kaplan–Meier survival analysis. Results Forty‐three uveal melanocytic lesions remained untreated and were retrospectively classified as benign nevi, whereas 69 lesions were malignant melanomas (T1: 32, T2: 28, T3: 6 and T4: 3). ‘Silent’ and ‘arcs without branching’ were found significantly more often in nevi (p = 0.001 and p = 0.010), whereas ‘parallel with cross‐linking’ and ‘networks’ were significantly more frequent in melanomas (p = 0.022 and p = 0.029). The microcirculation pattern ‘parallel with cross‐linking’ proved significantly more frequent in patients who developed metastases (p = 0.001). Conclusions Certain microcirculation patterns may guide us in differentiating uveal nevi from malignant melanomas. A non‐invasive prognostic marker can be of great value for borderline lesions in which cytology is less likely taken. ‘Parallel with cross‐linking’ did not only indicate malignancy, but it was also associated with later tumour metastasis.