一个中心 6934 名葡萄膜黑色素瘤患者肿瘤色素沉着的影响

IF 3.2 Q1 OPHTHALMOLOGY
Samuel J. Goldstein BSPH, Ferris Bayasi MD, George Thomas MD, Matthew Barke MD, Michael K. Nguyen BA, Samantha Pastore BS, Carol L. Shields MD
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引用次数: 0

摘要

目的评估脉络膜和睫状体葡萄膜黑色素瘤(UM)患者肿瘤色素沉着程度相关的临床特征和预后。方法收集患者人口统计学资料、肿瘤特征、治疗方法和临床预后。使用相关假设检验对色素性肿瘤(表面积色素沉着80%)、部分色素性肿瘤(20%-80%)和非色素性肿瘤(20%)进行比较。转移和黑色素瘤相关死亡的生存分析采用 Kaplan-Meier 法,单变量比较采用 log-rank 检验。主要结果指标眼外扩展、眼部黑色素细胞增多、肿瘤复发时间、肿瘤位置、黑色素瘤相关转移和死亡。结果6934只眼睛患有UM,肿瘤色素沉着程度分为色素沉着(n = 3762;54%)、部分色素沉着(n = 2115;31%)或非色素沉着(n = 1057;15%)。色素性 UM 与眼外扩展(P <;0.001)、眼部黑素细胞增多(P = 0.003)、肿瘤复发较早(P <;0.001)和肿瘤震中位置较前(睫状体、赤道部至血清轮)(P <;0.001)有关。色素性 UM 的 10 年转移率也最高,为 26%,而部分色素性 UM 为 19%,非色素性 UM 为 16%(P < 0.001)。卡普兰-梅耶生存曲线显示,不同色素沉着组的黑色素瘤相关转移率(P <0.001)和黑色素瘤相关死亡率(P <0.001)存在差异。黑色素瘤相关转移的多变量 Cox 回归分析显示,与部分色素沉着的 UMs 相比,色素沉着的 UMs 发生转移的相对风险高 29% (P = 0.结论色素性脉络膜和睫状体黑色素瘤通常与眼部黑素细胞增多、眼外扩展、肿瘤前部震中和肿瘤复发较早有关。我们还发现,与部分色素性和非色素性UMs相比,色素性UMs患者的10年转移率更高,转移生存率更低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of Tumor Pigmentation in 6934 Patients with Uveal Melanoma at a Single Center

Purpose

To evaluate clinical features and outcomes associated with degree of tumor pigmentation in patients with uveal melanoma (UM) of the choroid and ciliary body.

Design

Retrospective observational study.

Subjects

Six thousand nine hundred thirty-four consecutive patients with choroidal or ciliary body melanoma between 1971 and 2007 from a single ocular oncology center.

Methods

Data on patient demographics, tumor characteristics, treatment approach, and clinical outcomes were collected. Comparisons between pigmented (>80% pigmentation by surface area), partially pigmented (20%–80%), and nonpigmented tumors (<20%) were performed using relevant hypothesis testing. Survival analyses for metastasis and melanoma-related death were conducted using the Kaplan–Meier method with log-rank tests for univariate comparisons. A multivariate Cox regression analysis was performed to assess the independent effects of multiple covariates on time-to-metastasis.

Main Outcome Measures

Extraocular extension, ocular melanocytosis, time to tumor recurrence, tumor location, and melanoma-related metastasis and death.

Results

There were 6934 eyes with UM and the degree of tumor pigmentation was classified as pigmented (n = 3762; 54%), partially pigmented (n = 2115; 31%), or nonpigmented (n = 1057; 15%). Pigmented UM was associated with extraocular extension (P < 0.001), ocular melanocytosis (P = 0.003), earlier tumor recurrence (P < 0.001), and more anterior tumor epicenter location (ciliary body, and equator to ora serrata) (P < 0.001). Pigmented UMs also exhibited the highest 10-year metastasis rate at 26%, compared with 19% for partially pigmented UMs and 16% for nonpigmented UMs (P < 0.001). Kaplan–Meier survival curves demonstrated differences among the tumor pigmentation groups for melanoma-related metastasis (P < 0.001) and melanoma-related death (P < 0.001). Multivariate Cox regression analysis for melanoma-related metastasis showed that pigmented UMs had a 29% higher relative risk of developing metastasis compared with partially pigmented UMs (P = 0.002) and a 54% higher relative risk of developing metastasis compared with nonpigmented UMs (P < 0.001).

Conclusions

Pigmented choroidal and ciliary body melanoma is more often associated with ocular melanocytosis, extraocular extension, anterior tumor epicenter, and earlier tumor recurrence. We also revealed that patients with pigmented UMs demonstrate a higher 10-year rate of metastatic disease and have decreased metastatic survival relative to partially pigmented and nonpigmented UMs.

Financial Disclosures

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

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来源期刊
Ophthalmology science
Ophthalmology science Ophthalmology
CiteScore
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