Natalia C González, Victor M Villegas, Aaron S Gold, Azeema Latiff, Timothy G Murray
{"title":"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。","authors":"Natalia C González, Victor M Villegas, Aaron S Gold, Azeema Latiff, Timothy G Murray","doi":"10.1177/24741264251337101","DOIUrl":null,"url":null,"abstract":"<p><p><b>Purpose:</b> To evaluate the class 2 gene expression profiling of patients with small and medium-small uveal melanoma, focusing on tumor control, metastases, and mortality. <b>Methods:</b> 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. <b>Results:</b> 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%. <b>Conclusions:</b> 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.</p>","PeriodicalId":17919,"journal":{"name":"Journal of VitreoRetinal Diseases","volume":" ","pages":"24741264251337101"},"PeriodicalIF":0.5000,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031732/pdf/","citationCount":"0","resultStr":"{\"title\":\"Early Treatment in Patients With Small and Medium-Small Class 2 Gene Expression Profiling Uveal Melanoma to Reduce Mortality.\",\"authors\":\"Natalia C González, Victor M Villegas, Aaron S Gold, Azeema Latiff, Timothy G Murray\",\"doi\":\"10.1177/24741264251337101\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Purpose:</b> To evaluate the class 2 gene expression profiling of patients with small and medium-small uveal melanoma, focusing on tumor control, metastases, and mortality. <b>Methods:</b> 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. <b>Results:</b> 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%. <b>Conclusions:</b> 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.</p>\",\"PeriodicalId\":17919,\"journal\":{\"name\":\"Journal of VitreoRetinal Diseases\",\"volume\":\" \",\"pages\":\"24741264251337101\"},\"PeriodicalIF\":0.5000,\"publicationDate\":\"2025-04-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12031732/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of VitreoRetinal Diseases\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/24741264251337101\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of VitreoRetinal Diseases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/24741264251337101","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Early Treatment in Patients With Small and Medium-Small Class 2 Gene Expression Profiling Uveal Melanoma to Reduce Mortality.
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.