Chirurgie, cryocoagulation et radiotherapie combinee pour le traitement des melanomes de la conjonctive. [Combined surgery, cryocoagulation and radiotherapy for treatment of melanoma of the conjunctiva]

Détails

ID Serval
serval:BIB_F03EC7380863
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Chirurgie, cryocoagulation et radiotherapie combinee pour le traitement des melanomes de la conjonctive. [Combined surgery, cryocoagulation and radiotherapy for treatment of melanoma of the conjunctiva]
Périodique
Klinische Monatsblatter fur Augenheilkunde
Auteur(s)
Zografos  L., Uffer  S., Bercher  L., Gailloud  C.
ISSN
0023-2165 (Print)
Statut éditorial
Publié
Date de publication
05/1994
Volume
204
Numéro
5
Pages
385-90
Notes
English Abstract
Journal Article --- Old month value: May
Résumé
BACKGROUND: Conjunctival melanomas are malignant tumors with a high local recurrence rate after simple surgical excision. The rate of recurrence is particularly high in cases of large size tumor, of widespread tumors and with PAM associated lesions. Tumor recurrences have a bad long-term prognostic significance and often necessitate exenteration. PATIENTS AND METHODS: A method of therapy combining total surgical excision with proton-beam irradiation, cobalt plaque irradiation and cryotherapy is described. This technique is used in particular unfavorable cases with the aim of lowering the rate of recurrences. It was practiced in 19 cases in Lausanne, 10 of which were recurrent tumors. The melanoma invaded 3 quadrants of the bulbar conjunctiva in 8 cases and 4 quadrants in 11 cases. At least one neighbouring tarsal conjunctiva was invaded in 11 cases and both in 7 cases. The skin of the eyelid was infiltrated in 6 cases and the caruncle in 9 cases. Tumor thickness was 1 to 2 mm in 8 cases, 3 to 4 mm in 4 cases and 5 to 10 mm in 7 cases. RESULTS: PAM was present in 16 cases. Follow-up period was less than 1 year in 2 cases, between 1 to 2 years in 5 cases, between 2 to 3 years in 5 cases and more than 3 years in 7 cases. 5 patients had lymph node metastases, 3 died of metastatic disease and 2 had a local recurrence. One of these recurrences was small-sized and was excised, the other was widespread and the patient died soon with metastatic disease. No exenteration was performed. CONCLUSION: The method of therapy that is here described appears to be a valuable alternative to exenteration of the orbit for the treatment of diffuse or large-size conjunctival melanomas which have a high risk of local recurrence.
Mots-clé
Adult Aged *Brachytherapy Combined Modality Therapy Conjunctival Neoplasms/pathology/radiotherapy/*surgery *Cryosurgery Female Follow-Up Studies Humans Male Melanoma/pathology/radiotherapy/*surgery Middle Aged Neoplasm Recurrence, Local/etiology Radiotherapy Dosage Switzerland Visual Acuity/physiology
Pubmed
Web of science
Création de la notice
28/01/2008 14:09
Dernière modification de la notice
03/03/2018 22:36
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