Unexpectedly Low Rate of Metastasis and Death Among Patients Treated for Uveal Melanoma with Brachytherapy, Vitrectomy, and Silicone Oil.
Only 16.2% of uveal melanoma patients developed metastasis, far below historical rates.
Unexpectedly Low Rate of Metastasis and Death Among Patients Treated for Uveal Melanoma with Brachytherapy, Vitrectomy, and Silicone Oil.
Historically, approximately 30-32% of uveal melanoma patients develop metastases and die within 5 years.
Uveal melanoma patients treated by a single vitreoretinal surgical oncologist and monitored by a single medical oncologist were identified via a clinical database search for analysis.
We identified 37 uveal melanoma patients, followed for a median of 4.0 ± 3.7 years.
Twenty-seven (73%) patients underwent plaque brachytherapy with vitrectomy and silicone oil for radiation attenuation; seven (19%) patients underwent brachytherapy alone; three (8%) had enucleation.
Disomy 3 and Class 1 accurately predicted a low risk for metastasis (>90% negative predictive value).
However, monosomy 3 and Class 2 had a low positive predictive value and prognostic accuracy in "high-risk" patients.
In this single-center cohort, we observed an unexpectedly low rate of 5-year metastasis. AJCC stage correlated poorly with metastasis or survival.
Molecular prognostic results of Disomy 3 and Class 1 gene expression profile accurately predicted a "low" risk for metastasis (>90% negative predictive value). Further evaluation of these unique surgical techniques needs to be carried out.