Metastasis of Uveal Melanoma Millimeter-by-Millimeter in 8033 Consecutive Eyes
Metastasis of Uveal Melanoma Millimeter-by-Millimeter in 8033 Consecutive Eyes
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DOI：
10.1001/archophthalmol.2009.208
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发表时间：
2009-08-01
影响因子：
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通讯作者：
Shields, Jerry A.
中科院分区：
文献类型：
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作者：
Shields, Carol L.;Furuta, Minoru;Shields, Jerry A.
目的：根据肿瘤厚度（毫米）确定葡萄膜黑色素瘤的转移率。方法：回顾性病历回顾。结果：患者平均（中位）年龄为58（59）岁。共检查8033只眼。285眼虹膜黑色素瘤中，平均肿瘤厚度为2.7 mm，3年、5年和10年转移率分别为0.5%、4%和7%。睫状体黑色素瘤的492只眼中，平均肿瘤厚度为6.6 mm，3年、5年和10年时转移发生率分别为12%、19%和33%。7256眼脉络膜黑色素瘤中，平均肿瘤厚度为5.5 mm，3年、5年和10年时转移率分别为8%、15%和25%。对于所有葡萄膜黑色素瘤，小黑色素瘤（厚度0-3.0 mm）在5年、10年和20年时的转移率分别为6%、12%和20%，中型黑色素瘤（3.1-8.0 mm）为14%、26%和37%，大黑色素瘤（>8.0 mm）为35%、49%和67%。更具体地说，10年时每毫米增量的转移是6%，（0-1.0 mm厚度），12%（1.1-2.0毫米），12%（2.13.0 mm），16% 0 mm）、27%（4.1-5.0 mm）、28%（5.16.0 mm）、29%（6.1-7.0 mm）、41%（7.1-8.0 mm）、50%（8.19.0 mm）、44%（9.1-10.0 mm）和51%（>10.0 mm）。多变量分析预测转移的临床因素包括患者年龄的增加，睫状体的位置，增加肿瘤直径，增加肿瘤厚度，有一个棕色的肿瘤，并存在视网膜下液，眼内出血，或眼外extension.Conclusion：增加毫米厚度葡萄膜黑色素瘤与转移的风险增加。
Objective: To determine the rate of metastasis of uveal melanoma on the basis of tumor thickness in millimeters.Methods: Retrospective medical record review.Results: The mean (median) patient age was 58 (59) years. A total of 8033 eyes were examined. Of the 285 eyes with iris melanoma, the mean tumor thickness was 2.7 mm and metastasis occurred in 0.5%, 4%, and 7% at 3, 5, and 10 years, respectively. Of the 492 eyes with ciliary body melanoma, the mean tumor thickness was 6.6 mm and metastasis occurred in 12%, 19%, and 33% at 3, 5, and 10 years, respectively. Of the 7256 eyes with choroidal melanoma, the mean tumor thickness was 5.5 mm and metastasis occurred in 8%, 15%, and 25% at 3, 5, and 10 years, respectively. For all uveal melanoma, metastasis at 5, 10, and 20 years was 6%, 12%, and 20% for small melanoma (0-3.0 mm thickness), 14%, 26%, and 37% for medium melanoma (3.1-8.0 mm), and 35%, 49%, and 67% for large melanoma (>8.0 mm). More specifically, metastasis per millimeter increment at 10 years was 6% (0-1.0 mm thickness), 12% (1.1-2.0 mm), 12% (2.13.0 mm), 16% (3.1-4.0 mm), 27% (4.1-5.0 mm), 28% (5.16.0 mm), 29% (6.1-7.0 mm), 41% (7.1-8.0 mm), 50% (8.19.0 mm), 44% (9.1-10.0 mm), and 51% (>10.0 mm). Clinical factors predictive of metastasis by multivariate analysis included increasing patient age, ciliary body location, increasing tumor diameter, increasing tumor thickness, having a brown tumor, and the presence of subretinal fluid, intraocular hemorrhage, or extraocular extension.Conclusion: Increasing millimeter thickness of uveal melanoma is associated with increasing risk for metastasis.