González Natalia C, Villegas Victor M, Gold Aaron S, Latiff Azeema, Murray Timothy G
Department of Ophthalmology, University of Puerto Rico, San Juan, PR, USA.
Bascom Palmer Eye Institute, University of Miami, Miami, FL, USA.
J Vitreoretin Dis. 2025 Apr 25:24741264251337101. doi: 10.1177/24741264251337101.
To evaluate the class 2 gene expression profiling of patients with small and medium-small uveal melanoma, focusing on tumor control, metastases, and mortality. This retrospective case series evaluated patients treated for small or medium-small uveal melanoma by the same surgeon. Patients with small uveal melanoma were treated with microincision vitrectomy surgery or brachytherapy, and patients with medium-small uveal melanoma were treated with brachytherapy. All patients were gene expression profiling class 2. Forty-two patients (21 with a diagnosis of small melanoma; 21 with a diagnosis of medium-small melanoma) with a mean age of 58 years and a confirmed diagnosis of class 2 gene expression profiling melanoma were identified. The melanoma-specific mortality at the 5-year follow-up was 4.8% (1/21) for patients with small melanoma and 14.3% (3/21) for patients with medium-small melanoma. The rate of melanoma-specific active metastasis at 5 years was 4.8% (1/21) for patients with small melanoma and 14.3% (3/21) for patients with medium-small melanoma. In both groups, the enucleation rate at 5 years was 0%. Small tumor management achieves excellent anatomic and visual outcomes but mandates diagnostic accuracy and defined long-term outcomes as well as follow-up (5-year minimum in this series). Gene expression profiling classification is important in prognostication; however, early treatment of small tumors significantly decreases the predicted mortality and has the greatest potential effect on patient survival, even for class 2 melanomas.
评估中小脉络膜黑色素瘤患者的2类基因表达谱，重点关注肿瘤控制、转移和死亡率。本回顾性病例系列评估了由同一位外科医生治疗的中小脉络膜黑色素瘤患者。小脉络膜黑色素瘤患者接受了微切口玻璃体切除术或近距离放射治疗，中小脉络膜黑色素瘤患者接受了近距离放射治疗。所有患者均为2类基因表达谱。确定了42例患者（21例诊断为小黑色素瘤；21例诊断为中小黑色素瘤），平均年龄58岁，确诊为2类基因表达谱黑色素瘤。小黑色素瘤患者在5年随访时的黑色素瘤特异性死亡率为4.8%（1/21），中小黑色素瘤患者为14.3%（3/21）。小黑色素瘤患者5年时的黑色素瘤特异性活跃转移率为4.8%（1/21），中小黑色素瘤患者为14.3%（3/21）。两组在5年时的眼球摘除率均为0%。小肿瘤的治疗可实现出色的解剖和视觉效果，但需要诊断准确性、明确的长期结果以及随访（本系列至少5年）。基因表达谱分类在预后评估中很重要；然而，小肿瘤的早期治疗可显著降低预测死亡率，并对患者生存具有最大的潜在影响，即使对于2类黑色素瘤也是如此。
