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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