Early Treatment in Patients With Small and Medium-Small Class 2 Gene Expression Profiling Uveal Melanoma to Reduce Mortality.

IF 0.5 Q4 OPHTHALMOLOGY
Natalia C González, Victor M Villegas, Aaron S Gold, Azeema Latiff, Timothy G Murray
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Abstract

Purpose: To evaluate the class 2 gene expression profiling of patients with small and medium-small uveal melanoma, focusing on tumor control, metastases, and mortality. Methods: This retrospective case series evaluated patients treated for small or medium-small uveal melanoma by the same surgeon. Patients with small uveal melanoma were treated with microincision vitrectomy surgery or brachytherapy, and patients with medium-small uveal melanoma were treated with brachytherapy. All patients were gene expression profiling class 2. Results: Forty-two patients (21 with a diagnosis of small melanoma; 21 with a diagnosis of medium-small melanoma) with a mean age of 58 years and a confirmed diagnosis of class 2 gene expression profiling melanoma were identified. The melanoma-specific mortality at the 5-year follow-up was 4.8% (1/21) for patients with small melanoma and 14.3% (3/21) for patients with medium-small melanoma. The rate of melanoma-specific active metastasis at 5 years was 4.8% (1/21) for patients with small melanoma and 14.3% (3/21) for patients with medium-small melanoma. In both groups, the enucleation rate at 5 years was 0%. Conclusions: Small tumor management achieves excellent anatomic and visual outcomes but mandates diagnostic accuracy and defined long-term outcomes as well as follow-up (5-year minimum in this series). Gene expression profiling classification is important in prognostication; however, early treatment of small tumors significantly decreases the predicted mortality and has the greatest potential effect on patient survival, even for class 2 melanomas.

早期治疗中小2类基因表达谱葡萄膜黑色素瘤可降低死亡率。
目的:评估中小葡萄膜黑色素瘤患者的2类基因表达谱,重点关注肿瘤控制、转移和死亡率。方法:本回顾性病例系列评估由同一外科医生治疗的小或中小型葡萄膜黑色素瘤患者。小葡萄膜黑色素瘤患者采用小切口玻璃体切除术或近距离治疗,中、小葡萄膜黑色素瘤患者采用近距离治疗。所有患者均为基因表达谱2级。结果:42例患者(21例诊断为小黑色素瘤;21例(诊断为中小型黑色素瘤),平均年龄58岁,确诊为2类基因表达谱黑色素瘤。5年随访时,小黑色素瘤患者的黑色素瘤特异性死亡率为4.8%(1/21),中小黑色素瘤患者的死亡率为14.3%(3/21)。小型黑色素瘤患者5年黑色素瘤特异性活性转移率为4.8%(1/21),中小型黑色素瘤患者5年黑色素瘤特异性活性转移率为14.3%(3/21)。两组5年时的去核率均为0%。结论:小肿瘤治疗获得了良好的解剖和视觉效果,但要求诊断准确性和明确的长期预后以及随访(本系列中至少5年)。基因表达谱分类对预后有重要意义;然而,小肿瘤的早期治疗显著降低了预测死亡率,对患者生存有最大的潜在影响,即使是2级黑色素瘤。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
1.20
自引率
16.70%
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