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Am J Ophthalmol. 2012 Aug;154(2):227-232.e2. doi: 10.1016/j.ajo.2012.02.022. Epub 2012 Apr 27.

Uveal melanoma: molecular pattern, clinical features, and radiation response.

Author information

1
California Pacific Medical Center, San Francisco, California, USA.

Abstract

PURPOSE:

To characterize the clinical spectrum of class 1 and class 2 uveal melanomas and their relationship with intraocular proton radiation response.

DESIGN:

Masked retrospective case series of uveal melanoma patients with fine needle biopsy-based molecular profiles.

METHODS:

A total of 197 uveal melanoma patients from a single institution were analyzed for pathology, clinical characteristics, and response to radiation therapy.

RESULTS:

A total of 126 patients (64%) had class 1 tumors and 71 (36%) had class 2 tumors. Patients with class 2 tumors had more advanced age (mean: 64 years vs 57 years; P = .001), had thicker initial mean ultrasound measurements (7.4 mm vs 5.9 mm; P = .0007), and were more likely to have epithelioid or mixed cells on cytopathology (66% vs 38%; P = .0004). Although mean pretreatment and posttreatment ultrasound thicknesses were significantly different between class 1 and class 2 tumors, there was no difference in the mean change in thickness 24 months after radiation therapy (mean difference: class 1 = -1.64 mm, class 2 = -1.47; P = .47) or in the overall rate of thickness change (slope: P = .64). Class 2 tumors were more likely to metastasize and cause death than class 1 tumors (DSS: P < .0001).

CONCLUSIONS:

At the time of radiation therapy, thicker tumors, epithelioid pathology, and older patient age are significantly related to class 2 tumors, and class 2 tumors result in higher tumor-related mortality. We found no definitive clinical marker for differentiating class 1 and class 2 tumors.

PMID:
22541662
PMCID:
PMC4966158
DOI:
10.1016/j.ajo.2012.02.022
[Indexed for MEDLINE]
Free PMC Article

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