Risk-stratified systemic surveillance in uveal melanoma
Risk-stratified systemic surveillance in uveal melanoma
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DOI：
10.1136/bjophthalmol-2018-313569
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发表时间：
2019-12-01
影响因子：
4.1
通讯作者：
Singh, Arun D.
中科院分区：
文献类型：
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作者：
Davanzo, Jacquelyn M.;Binkley, Elaine M.;Singh, Arun D.
背景/目的分子生物学为葡萄膜黑色素瘤患者提供临床上可应用的预后信息。大多数眼科肿瘤学家建议对高危肿瘤患者进行密集的转移监测。然而，社会经济变量可能会限制患者坚持推荐监测的能力。我们的目的是分析葡萄膜黑色素瘤患者的社会经济学数据，这些患者接受了分子生物学治疗，以确定哪些变量影响依从性。方法回顾性分析2014年1月至2015年6月107例葡萄膜黑色素瘤患者的临床资料。将患者分为低/未知转移风险和高转移风险。低风险组每6个月随访一次肝脏超声检查。对高风险组进行更频繁的肝脏成像或将肝脏CT/MRI纳入监测方案。在主要治疗后的前2年记录对监测建议的依从性。记录社会经济学数据，包括诊断时的年龄、基线系统分期、基因表达谱状态、婚姻状况、保险、主要居住地距离、家庭收入中位数和Charlson Comorbid指数评分。还记录了成像的频率/模式和转移状态。结果高危患者发生转移的可能性高于低危/未知危患者（p
Background/Aim Molecular prognostication provides clinically applicable prognostic information for patients with uveal melanoma. Most ocular oncologists recommend intensive metastatic surveillance for patients with high-risk tumours. However, socioeconomic variables may limit a patient's ability to adhere to recommended surveillance. We aim to analyse socioeconomic data from patients with uveal melanoma who underwent molecular prognostication to determine which variables influence adherence. Methods This was a retrospective review of 107 consecutive patients who were diagnosed and treated for uveal melanoma from January 2014 to June 2015. Patients were categorised into low/unknown risk and high risk for metastasis. The low-risk group was followed with hepatic ultrasonography every 6 months. The high-risk group was followed with more frequent hepatic imaging or incorporation of hepatic CT/MRI into the surveillance protocol. Adherence to surveillance recommendations was recorded for the first 2 years following primary treatment. Socioeconomic data including age at diagnosis, baseline systemic staging, gene expression profile status, marital status, insurance, distance of primary residence, median household income and Charlson Comorbidity Index score were recorded. Frequency/modality of imaging and metastatic status were also recorded. Results High-risk patients were more likely to develop metastasis than low-risk/unknown-risk patients (p