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Ten year results of transscleral resection of large uveal melanomas: Local tumour control and metastatic rate
  1. Nikolaos E. Bechrakis1,*,
  2. Vasileios E Petousis2,
  3. Gregor Willerding2,
  4. Lothar Krause3,
  5. Joachim Wachtlin4,
  6. Andrea Stroux5,
  7. Michael H Foerster2
  1. 1 Department of Ophthalmology, Innsbruck Medical University, Austria;
  2. 2 Department of Ophthalmology, Campus Benjamin Franklin, Charité – Medical University, Berlin, Germany;
  3. 3 Department of Ophthalmology, Städtisches Klinikum Dessau, Dessau, Germany;
  4. 4 Department of Ophthalmology, Sankt Getrauden, Berlin, Germany;
  5. 5 Institute for Biostatistics, Charité – Medical University, Berlin, Germany
  1. Correspondence to: Nikolaos E. Bechrakis, Department of Ophthalmology, Medical University of Innsbruck, Anichstr. 35, Innsbruck, A-6020, Austria; nikolaos.bechrakis{at}i-med.ac.at

Abstract

Aims: To describe the long-term tumour control and metastatic rate after transscleral resection (TSR) of large uveal melanomas in a single-centre study.

Methods: The sample included 210 patients with large uveal melanomas.

Univariate analysis of local tumour control and metastatic risk by Kaplan-Meier survival curves and log-rank testing. Cox proportional hazard ratio (HR) analysis with forward and backward selection was used to identify independent prognostic factors in patients submitted to TSR of a large uveal melanoma.

Results: A residual tumour was diagnosed in 6% of the patients. The 5- and 10-year local tumour recurrence rates were 24% and 32%. Older age, a large basal tumour diameter, the lack of adjuvant ruthenium brachytherapy and retinal detachment led to a 2.6, 2.4, 4.4, and 7.8 times higher risk of melanoma recurrence. The 5- and 10-year metastatic rates were 28% and 44% and statistical significantly affected from extraocular spread, tumour thickness and local tumour recurrence.

Conclusions: TSR is an alternative to enucleation for the treatment of large uveal melanomas. Results should improve with better patient selection and more effective methods of adjuvant radiotherapy.

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