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Metastatic disease in small uveal melanomas : retrospective review of 368 patients
Author(s) -
DESJARDINS L,
LEVY GABRIEL C,
LUMBROSOLEROUIC L,
DENDALE R,
PLANCHER C,
ASSELAIN B
Publication year - 2009
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/j.1755-3768.2009.4161.x
Subject(s) - medicine , radiation therapy , retrospective cohort study , melanoma , metastasis , uvea , radiology , nuclear medicine , surgery , cancer , cancer research
Purpose To determine the metastatic rate and survival curves of small uveal melanomas and find the smallest uveal melanoma associated with metastatic disease. Methods We studied uveal melanomas patients treated with radiotherapy in Curie Institute between 1992 and 2004. We selected the tumors with a diameter inferior or equal to 12 mm and a thickness inferior or equal to 3 mm. All the datas concerning initial tumor findings, radiotherapy treatment and follow up were routinely entered in the data base. Retrospective review and statistical analysis were performed. Results Among 2258 patients treated during this period, 368 had small tumors. Median tumor diameter was 9 mm and median tumor thickness was 2,5 mm. Retinal detachment was present in 32 patients. 282 patients were treated by proton beam therapy, 77 by iodine plaque and 9 by transpupillary thermotherapy. Median follow up is 109 months. 71 patients died and 20 patients developped metastatic disease. Local recurrence was observed in two cases. Overall survival at 5 years was 92%and at 10 years 78% survival without metastasis at 5 years was 96% and at 10 years 93%. According to our data the smallest tumor associated with metastatic death was 5mm in diameter and 1,5 mm in thickness and 14 of the tumors had a diameter of less than 10 mm develloped. Half of the metastatic patients developped metastasis 5 years or more after treatment. Conclusion Very small uveal melanoma can be responsible for metastatic death.