Goldstein Samuel J, Bayasi Ferris, Thomas George, Barke Matthew, Nguyen Michael K, Pastore Samantha, Shields Carol L
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, 840 Walnut Street, 14th Floor, Philadelphia, Pennsylvania, 19107.
Ophthalmol Sci. 2024 Jul 26;4(6):100585. doi: 10.1016/j.xops.2024.100585. eCollection 2024 Nov-Dec.
To evaluate clinical features and outcomes associated with degree of tumor pigmentation in patients with uveal melanoma (UM) of the choroid and ciliary body.
Retrospective observational study.
Six thousand nine hundred thirty-four consecutive patients with choroidal or ciliary body melanoma between 1971 and 2007 from a single ocular oncology center.
Data on patient demographics, tumor characteristics, treatment approach, and clinical outcomes were collected. Comparisons between pigmented (>80% pigmentation by surface area), partially pigmented (20%-80%), and nonpigmented tumors (<20%) were performed using relevant hypothesis testing. Survival analyses for metastasis and melanoma-related death were conducted using the Kaplan-Meier method with log-rank tests for univariate comparisons. A multivariate Cox regression analysis was performed to assess the independent effects of multiple covariates on time-to-metastasis.
Extraocular extension, ocular melanocytosis, time to tumor recurrence, tumor location, and melanoma-related metastasis and death.
There were 6934 eyes with UM and the degree of tumor pigmentation was classified as pigmented (n = 3762; 54%), partially pigmented (n = 2115; 31%), or nonpigmented (n = 1057; 15%). Pigmented UM was associated with extraocular extension ( < 0.001), ocular melanocytosis ( = 0.003), earlier tumor recurrence ( < 0.001), and more anterior tumor epicenter location (ciliary body, and equator to ora serrata) ( < 0.001). Pigmented UMs also exhibited the highest 10-year metastasis rate at 26%, compared with 19% for partially pigmented UMs and 16% for nonpigmented UMs ( < 0.001). Kaplan-Meier survival curves demonstrated differences among the tumor pigmentation groups for melanoma-related metastasis ( < 0.001) and melanoma-related death ( < 0.001). Multivariate Cox regression analysis for melanoma-related metastasis showed that pigmented UMs had a 29% higher relative risk of developing metastasis compared with partially pigmented UMs ( = 0.002) and a 54% higher relative risk of developing metastasis compared with nonpigmented UMs ( < 0.001).
Pigmented choroidal and ciliary body melanoma is more often associated with ocular melanocytosis, extraocular extension, anterior tumor epicenter, and earlier tumor recurrence. We also revealed that patients with pigmented UMs demonstrate a higher 10-year rate of metastatic disease and have decreased metastatic survival relative to partially pigmented and nonpigmented UMs.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
评估脉络膜和睫状体葡萄膜黑色素瘤（UM）患者的临床特征及与肿瘤色素沉着程度相关的预后。
回顾性观察研究。
1971年至2007年期间来自单个眼科肿瘤中心的6934例连续性脉络膜或睫状体黑色素瘤患者。
收集患者人口统计学、肿瘤特征、治疗方法及临床预后的数据。对色素沉着型（表面积色素沉着>80%）、部分色素沉着型（20%-80%）和无色素型肿瘤（<20%）进行相关假设检验比较。采用Kaplan-Meier法及对数秩检验进行单因素比较，对转移和黑色素瘤相关死亡进行生存分析。进行多因素Cox回归分析以评估多个协变量对转移时间的独立影响。
眼外扩展、眼内黑色素细胞增多症、肿瘤复发时间、肿瘤位置以及黑色素瘤相关转移和死亡。
共有6934只眼患有UM，肿瘤色素沉着程度分为色素沉着型（n = 3762；54%）、部分色素沉着型（n = 2115；31%）或无色素型（n = 1057；15%）。色素沉着型UM与眼外扩展（P < 0.001）、眼内黑色素细胞增多症（P = 0.003）、较早的肿瘤复发（P < 0.001）以及更靠前的肿瘤中心位置（睫状体、赤道至锯齿缘）（P < 0.001）相关。色素沉着型UM的10年转移率最高，为26%，部分色素沉着型UM为19%，无色素型UM为16%（P < 0.
