Patients presenting with metastases: stage IV uveal melanoma, an international study
| Autor: | Tero Kivelä, Brenda L. Gallie, Matthew W. Wilson, Martine J. Jager, J.M. Caminal, Anibal Martin Folgar, Gregorius P M Luyten, Stefan Seregard, Gaurav Garg, Paul T. Finger, Cristina Gutiérrez, Vladimir Valskiy, Shigenobu Suzuki, Kimberly J. Chin, Mehmet Dogrusöz, Anush Amiryan, Barrett G. Haik, E. Rand Simpson, Maria Fili, Jaume Català-Mora, Ekaterina Semenova, S.V. Saakyan, David E. Pelayes, Arun D. Singh |
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| Přispěvatelé: | HUS Head and Neck Center, Silmäklinikka |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Uveal Neoplasms
medicine.medical_specialty retina PROGNOSIS Iris CHOROIDAL MELANOMA DIAGNOSIS DISEASE Metastasis 03 medical and health sciences Cellular and Molecular Neuroscience 0302 clinical medicine Ciliary body TOMOGRAPHY medicine Humans 3125 Otorhinolaryngology ophthalmology Stage (cooking) Lymph node Melanoma Neoplasm Staging Retrospective Studies business.industry ciliary body Cancer imaging medicine.disease CANCER Sensory Systems Ophthalmology medicine.anatomical_structure 030220 oncology & carcinogenesis 030221 ophthalmology & optometry SURVIVAL Radiology Choroid OCULAR MELANOMA business choroid Subcutaneous tissue CT |
| Zdroj: | British Journal of Ophthalmology, 106(4). BMJ PUBLISHING GROUP |
| Popis: | ObjectiveTo analyse ocular and systemic findings of patients presenting with systemic metastasis.Methods and analysisIt 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.ResultsOf 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.ConclusionsThough 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. |
| Databáze: | OpenAIRE |
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