Patients presenting with metastases: stage IV uveal melanoma, an international study.
Details
Serval ID
serval:BIB_7CC43C04C3D4
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Patients presenting with metastases: stage IV uveal melanoma, an international study.
Journal
The British journal of ophthalmology
Working group(s)
AJCC Ophthalmic Oncology Task Force
Contributor(s)
Finger P.T., Coupland S.E., Albert D.M., Amiryan A.G., Saakyan S., Auw-Hädrich C., Baker D., Barnhill R., Caminal J.M., Caroll W.L., Cassoux N., Desjardins L.G., Pierron G., Catalá-Mora J., Chantada G., Chévez-Barrios P., Max Conway R., Damato B.E., Demirci H., Dutton J.J., Esmaeli B., Prieto V.G., Williams M., Gallie B.L., Graue G.F., Grossniklaus H.E., Heegaard S., Holbach L.M., Honavar S.G., Jager M.J., Kivelä T.T., Kujala E., Rouic L.L., Mallipatna A.C., Modorati G.M., Munier F.L., Murray T.G., Pavlick A.C., Pe'er J., Pelayes D.E., Rodrigues M., Sauerwein WAG, Semenova E., Seregard S., Shields C., Rand Simpson E., Singh A.D., Suzuki S., Washington M.K., White V.A., Wilson M.W., Wittekind C.W., Yin V.
ISSN
1468-2079 (Electronic)
ISSN-L
0007-1161
Publication state
Published
Issued date
04/2022
Peer-reviewed
Oui
Volume
106
Number
4
Pages
510-517
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Publication Status: ppublish
Abstract
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.
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.
Keywords
Humans, Melanoma/pathology, Neoplasm Staging, Prognosis, Retrospective Studies, Uveal Neoplasms/pathology, Iris, choroid, ciliary body, imaging, retina
Pubmed
Web of science
Open Access
Yes
Create date
13/11/2023 10:56
Last modification date
18/11/2023 8:07
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