Prognosis and determinants of survival after orbital exenteration for conjunctival melanoma: Experiences from a Dutch Referral Centre.

IF 2.8 3区医学 Q1 OPHTHALMOLOGY

Acta Ophthalmologica Pub Date : 2025-07-11 DOI:10.1111/aos.17553

David Chetroiu, Niels J Brouwer, Marina Marinkovic, Gregorius P M Luyten, Jaco C Bleeker, Robert M Verdijk, T H Khanh Vu, Stijn W van der Meeren

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引用次数: 0

Abstract

Purpose: To assess the prognosis and determinants of survival after orbital exenteration in patients with conjunctival melanoma (CoM).

Methods: In a retrospective study, 27 consecutive patients who underwent exenteration for CoM from 2001 to 2023 were included. Overall survival (OS), progression-free survival (PFS) and their risk factors were analysed.

Results: The mean follow-up time since orbital exenteration was 42 ± 37 months. Eyelid sparing orbital exenteration was achieved in 24 patients (89%). Two patients (7%) developed local recurrences. Seven patients (26%) developed distant metastasis resulting in a metastasis-free survival of 100% at 1 year and 63% at 5 years. The PFS was 100% and 63% at 1 and 5 years, respectively. The OS for 1, 5 and 10 years was 92, 57 and 31%, respectively. Presence of recurrences prior to exenteration and longer time from diagnosis to exenteration were related to worse OS (both p = 0.02). Presence of metastasis prior to exenteration, orbital invasion and tumour-containing resection margins were related to a worse PFS at 5 years (p = 0.03, p = 0.03 and p = 0.02, respectively).

Conclusion: For CoM patients treated with orbital exenteration, the presence of metastases and recurrences prior to exenteration, longer time from diagnosis to exenteration, orbital invasion and tumour-containing resection margins are unfavourable prognostic factors. Our study demonstrates relatively favourable outcomes, with no difference in survival between eyelid sparing or eyelid removing techniques, calling to consider orbital exenteration for advanced CoM cases when other (newer) therapies are not applicable.

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眼眶摘除结膜黑色素瘤后的预后和生存的决定因素：来自荷兰转诊中心的经验。

目的：探讨结膜黑色素瘤（CoM）患者眼眶摘除术后的预后及影响生存的因素。方法：在一项回顾性研究中，纳入了从2001年到2023年连续27例因CoM接受清除术的患者。分析总生存期（OS）、无进展生存期（PFS）及其危险因素。结果：术后平均随访时间为42±37个月。24例患者（89%）成功完成了保留眼睑的眼眶摘除。2例（7%）发生局部复发。7例患者（26%）发生远处转移，1年无转移生存率为100%，5年无转移生存率为63%。1年和5年的PFS分别为100%和63%。1年、5年和10年的总生存率分别为92%、57%和31%。拔除前复发和从诊断到拔除的时间较长与较差的OS相关（p = 0.02）。在切除前存在转移，眼眶侵犯和肿瘤切除边缘与5年较差的PFS相关（p = 0.03, p = 0.03和p = 0.02）。结论：对于行眶内剜除术的CoM患者，剜除前存在转移和复发，从诊断到剜除的时间较长，眶内侵犯和肿瘤切除缘是不利预后的因素。我们的研究显示了相对有利的结果，保留眼睑和去除眼睑技术在生存率上没有差异，这呼吁在其他（较新的）治疗不适用的情况下，考虑眼眶剜除术。

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

Acta Ophthalmologica 医学-眼科学

CiteScore

7.60

自引率

5.90%

发文量

433

审稿时长

6 months

期刊介绍： Acta Ophthalmologica is published on behalf of the Acta Ophthalmologica Scandinavica Foundation and is the official scientific publication of the following societies: The Danish Ophthalmological Society, The Finnish Ophthalmological Society, The Icelandic Ophthalmological Society, The Norwegian Ophthalmological Society and The Swedish Ophthalmological Society, and also the European Association for Vision and Eye Research (EVER). Acta Ophthalmologica publishes clinical and experimental original articles, reviews, editorials, educational photo essays (Diagnosis and Therapy in Ophthalmology), case reports and case series, letters to the editor and doctoral theses.