Survival in small choroidal melanocytic lesions with risk factors managed by initial observation until detection of tumour growth.

Autor: Vigués-Jorba L; Department of Ophthalmology, Ocular Oncology and Vitreoretinal Service, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Morwani R; Department of Ophthalmology, Ocular Oncology and Vitreoretinal Service, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Lorenzo D; Department of Ophthalmology, Ocular Oncology and Vitreoretinal Service, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Baradad-Jurjo MC; Department of Ophthalmology, Ocular Oncology and Vitreoretinal Service, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Arias L; Department of Ophthalmology, Ocular Oncology and Vitreoretinal Service, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Piulats JM; Department of Oncology, Catalan Institute of Oncology, Avinguda de la Gran Vía de l'Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain., Gutiérrez C; Department of Brachytherapy, Catalan Institute of Oncology, Avinguda de la Gran Vía de l'Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain., Cobos E; Department of Ophthalmology, Ocular Oncology and Vitreoretinal Service, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Garcia-Bru P; Department of Ophthalmology, Ocular Oncology and Vitreoretinal Service, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Caminal JM; Department of Ophthalmology, Ocular Oncology and Vitreoretinal Service, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
Jazyk: angličtina
Zdroj: Clinical & experimental ophthalmology [Clin Exp Ophthalmol] 2021 Apr; Vol. 49 (3), pp. 251-259. Date of Electronic Publication: 2021 Mar 09.
DOI: 10.1111/ceo.13911
Abstrakt: Background: The main objective was to describe metastatic and survival rates in patients with small choroidal melanocytic lesions initially managed by observation.
Methods: Retrospective, observational study of consecutive cases recruited from 2001 through 2018, followed for a median (mean, range) of 81.0 (89.3, 10-204) months in a tertiary referral centre for ocular oncology. Seventy-five consecutive patients diagnosed with small choroidal melanocytic lesions with risk factors for growth initially observed and who showed progression during follow-up. Treatment was performed (plaque radiotherapy or enucleation in 96% and 4% of cases, respectively) at detection of tumour growth.
Results: Median (mean, range) tumour thickness was 2.2 (2.23, 1.08-3.40) mm, and median maximum basal diameter was 8.5 (8.16, 4-12) mm. At diagnosis, a median (mean, range) of 5 (5.48, 1-8) risk factors for progression were present. Lesions grew at a median (mean, range) rate of 0.42 mm/y (1.12, 0-7.68) in thickness and 1.05 mm/y (3.14, 0-4.8) in maximum diameter. Median (mean, range) time until growth was 17.00 (32.6, 1-161) months post-diagnosis, at which time tumours were treated. Five patients developed local recurrence after brachytherapy requiring enucleation. Four patients developed hepatic metastasis. Melanoma-specific survival was 98% at 5 years (95% CI, 94.2-100%) and 91.6% (95% CI, 82-100%) at 10 and 15 years.
Conclusion: In small melanocytic lesions with risk factors for growth, initial observation until detection of tumour growth results in a seemingly low risk of metastasis, suggesting that this may be an initial approach to consider in tumours with indeterminate malignant potential.
(© 2021 Royal Australian and New Zealand College of Ophthalmologists.)
Databáze: MEDLINE
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