RT Journal Article
SR Electronic
T1 Patients presenting with metastases: stage IV uveal melanoma, an international study
JF British Journal of Ophthalmology
JO Br J Ophthalmol
FD BMJ Publishing Group Ltd.
SP 510
OP 517
DO 10.1136/bjophthalmol-2020-317949
VO 106
IS 4
A1 Gaurav Garg
A1 Paul T Finger
A1 Tero T Kivelä
A1 E Rand Simpson
A1 Brenda L Gallie
A1 Svetlana Saakyan
A1 Anush G Amiryan
A1 Vladimir Valskiy
A1 Kimberly J Chin
A1 Ekaterina Semenova
A1 Stefan Seregard
A1 Maria Filì
A1 Matthew Wilson
A1 Barrett Haik
A1 Josep Maria Caminal
A1 Jaume Catala-Mora
A1 Cristina Gutiérrez
A1 David E Pelayes
A1 Anibal Martin Folgar
A1 Martine Johanna Jager
A1 Mehmet Doğrusöz
A1 Gregorius P M Luyten
A1 Arun D Singh
A1 Shigenobu Suzuki
A1 ,
YR 2022
UL http://bjo.bmj.com/content/106/4/510.abstract
AB Objective To analyse ocular and systemic findings of patients presenting with systemic metastasis.Methods and analysis It is an international, multicentre, internet-enabled, registry-based retrospective data analysis. Patients were diagnosed between 2001 and 2011. Data included: primary tumour dimensions, extrascleral extension, ciliary body involvement, American Joint Committee on Cancer (AJCC)-tumour, node, metastasis staging, characteristics of metastases.Results Of 3610 patients with uveal melanoma, 69 (1.9%; 95% CI 1.5 to 2.4) presented with clinical metastasis (stage IV). These melanomas originated in the iris, ciliary body and choroid in 4%, 16% and 80% of eyes, respectively. Using eighth edition AJCC, 8 (11%), 20 (29%), 24 (35%), and 17 (25%) belonged to AJCC T-categories T1–T4. Risk of synchronous metastases increased from 0.7% (T1) to 1.5% (T2), 2.6% (T3) and 7.9% (T4). Regional lymph node metastases (N1a) were detected in 9 (13%) patients of whom 6 (67%) had extrascleral extension. Stage of systemic metastases (known for 40 (59%) stage IV patients) revealed 14 (35%), 25 (63%) and 1 (2%) had small (M1a), medium-sized (M1b) and large-sized (M1c) metastases, respectively. Location of metastases in stage IV patients were liver (91%), lung (16%), bone (9%), brain (6%), subcutaneous tissue (4%) and others (5%). Multiple sites of metastases were noted in 24%. Compared with the 98.1% of patients who did not present with metastases, those with synchronous metastases had larger intraocular tumours, more frequent extrascleral extension, ciliary body involvement and thus a higher AJCC T-category.Conclusions Though higher AJCC T-stage was associated with risk for metastases at diagnosis, even small T1 tumours were stage IV at initial presentation. The liver was the most common site of metastases; however, frequent multiorgan involvement supports initial whole-body staging.Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information. All data relevant to the study are included in the article or uploaded as supplementary information. Data are available upon reasonable request.