LARGE UVEAL MELANOMA (≥10 MM THICKNESS): Clinical Features and Millimeter-by-Millimeter Risk of Metastasis in 1311 Cases. The 2018 Albert E. Finley Lecture

Purpose: To analyze the clinical features and rate of metastatic disease in eyes with large (≥10 mm thickness) uveal melanoma. Design: Retrospective noncomparative case series. Participants: There were 1,311 consecutive patients. Methods: Retrospective medical chart review. Main outcome measures: Clinical features and rate of metastatic melanoma. Results: Of 1,311 patients with large melanoma, the mean age was 59 years (median 60, range 6–98 years) and 95% were white. Mean tumor basal dimension was 17 mm (median 17, range 7–25 mm), and mean tumor thickness was 12 mm (median 12, range 10–24 mm). Mean distance to the foveola was 6 mm (median 6, range 0–19 mm) and to optic nerve was 6 mm (median 5, range 0–19 mm). Of all eyes, using Kaplan–Meier analysis, metastasis occurred in 11, 30, 45, and 52% at 1, 3, 5, and 7 years, respectively. According to tumor thickness (10.0–11.0, 11.1–12.0, 12.1–13.0, 13.1–14.0, 14.1–15.0, 15.1–16.0, and>16.0 mm), metastasis at 1 year was found in 7, 12, 13, 15, 18, 22, and 20%; metastasis at 3 years was 24, 27, 37, 35, 51, 69, and 57%; metastasis at 5 years was 38%, 42%, 56%, 48%, 61%, not available, and 66%; and metastasis at 7 years was 47%, 47%, 61%, 57%, 61%, not available, and 66%. Clinical features associated with fewer metastatic events included Bruch membrane rupture (7-year metastasis at 48%, P = 0.018) and macular location (7-year metastasis at 32%, P = 0.014), whereas those with worse outcome in...
Source: RETINA - Category: Opthalmology Tags: Original Study Source Type: research