Ophthalmic Pathology and Oncology Service, St. Erik Eye Hospital, Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Acta Ophthalmol. 2018 Aug;96(5):510-518. doi: 10.1111/aos.13668. Epub 2018 Jan 16.
The aim of this study was to compare conventional and novel size estimation methods' ability to predict survival in uveal melanoma (UM).
The study was designed as a retrospective consecutive chart review of patients with UM, enucleated between the years 1984 and 1993. Area and volume were estimated based on the largest histopathological cross-section, the second centroid theorem of Pappus and digital image analysis, correlated to overall and relative survival.
Of 168 patients analysed, 20 (12%) of tumours were categorized as T1, 47 (28%) as T2, 67 (40%) as T3 and 19 (11%) as T4 (15 N/a). A total of 91 tumours with complete survival and measurement data were included and recategorized into small, medium and large volume groups. Increased separation of overall survival was seen compared with current American Joint Committee on Cancer T categories. Difference between the large and small volume groups was 8.6 years (p = 0.001), compared to a difference of 5.6 years (p = 0.091) between T1 and T4. Hazard ratio for all-cause mortality in the large versus small volume group was 2.6 compared to 1.9 for T4 versus T1. Relative survival rates for small, medium and large volumes were 62, 44 and 31% at 10 years, versus 50, 45, 56 and 0% for T1, T2, T3 and T4.
This study provides evidence that a novel UM volume estimation method might offer a practical and cost-efficient alternative to improve the prognostic value intrinsic to a tumour's size.
本研究旨在比较传统和新型大小估计方法预测葡萄膜黑色素瘤（UM）患者生存的能力。
本研究设计为回顾性连续病例分析，纳入 1984 年至 1993 年间行眼球摘除术的 UM 患者。基于最大组织病理学横切面、Pappus 第二质心定理和数字图像分析，估计面积和体积，并与总生存率和相对生存率相关联。
在分析的 168 例患者中，20 例（12%）肿瘤分为 T1，47 例（28%）为 T2，67 例（40%）为 T3，19 例（11%）为 T4（15 例未分类）。共有 91 例肿瘤具有完整的生存和测量数据，被重新分为小、中、大体积组。与目前的美国癌症联合委员会 T 分期相比，总生存率的分离程度增加。大体积组与小体积组之间的差异为 8.6 年（p=0.001），而 T1 与 T4 之间的差异为 5.6 年（p=0.091）。大体积组与小体积组的全因死亡率风险比为 2.6，而 T4 与 T1 相比为 1.9。小、中、大体积组的 10 年相对生存率分别为 62%、44%和 31%，而 T1、T2、T3 和 T4 组分别为 50%、45%、56%和 0%。
本研究提供了证据表明，一种新型 UM 体积估计方法可能提供一种实用且具有成本效益的替代方法，以提高肿瘤大小固有的预后价值。
