Bansal Rolika, Sener Hidayet, Shields Jerry A, Shields Carol L
Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, USA.
Indian J Ophthalmol. 2025 Jun 1;73(6):893-899. doi: 10.4103/IJO.IJO_2453_24. Epub 2025 May 28.
To estimate metastasis of patients with uveal melanoma (UM) based on tumor size categories classified by ultrasonographic thickness as small (0.0-3.0 mm), medium (3.1-8.0 mm), or large (≥8.1 mm) using both non-conditional and conditional analyses.
Retrospective analysis.
A retrospective study of 8034 cases over 35-years at a single ocular oncology referral center evaluated the primary endpoint of cumulative incidence of metastasis at 5-, 10-, 15-, 20-, 25- and 30-years using non-conditional and conditional analysis at 3-years, 5-years, and 10-years of metastasis-free survival.
The mean thicknesses for small, medium, and large UMs were 2.5 mm, 5.0 mm, and 10.2 mm, respectively. Based on tumor size category (small vs. medium vs. large), the 25-year non-conditional metastasis was 5% vs. 12% vs. 21%, and for those with 3-year metastasis-free survival, the 25-year incidence of metastasis was 7% vs. 13% vs. 26%. For those with 5-year metastasis-free survival, the 25-year incidence of metastasis was 6% vs. 11% vs. 21%. For those with 10-year metastasis-free survival, the 25-year incidence of metastasis was 4% vs. 8% vs. 21%. For small vs. medium UM, by conditional analysis, those who maintained 3-year/5-year/10-year metastasis-free survival, hazard ratio was 1.50 (P <0.01)/1.53 (P <0.01)/1.77 (P = 0.01), and for medium vs. large UM, hazard ratio was 1.45 (P <0.01)/1.44 (P = 0.03)/1.96 (P = 0.06).
Long-term comparative analysis of UM metastasis, based on tumor size category (thickness) as small, medium, or large, revealed that large UM is more likely with higher tendency to develop metastasis over time. The patients achieving 3-, 5-, and 10-year metastasis-free survival demonstrated significantly reduced subsequent risk of metastasis across all tumor size categories.
基于超声测量厚度分类的肿瘤大小类别（小：0.0 - 3.0毫米、中：3.1 - 8.0毫米、大：≥8.1毫米），使用非条件分析和条件分析评估葡萄膜黑色素瘤（UM）患者的转移情况。
回顾性分析。
在一个单一的眼科肿瘤转诊中心对8034例患者进行了为期35年的回顾性研究，使用非条件分析和在无转移生存3年、5年和10年时的条件分析评估5年、10年、15年、20年、25年和30年时转移累积发生率的主要终点。
小、中、大葡萄膜黑色素瘤的平均厚度分别为2.5毫米、5.0毫米和10.2毫米。基于肿瘤大小类别（小 vs. 中 vs. 大），25年非条件转移率分别为5%、12%和21%，对于无转移生存3年的患者，25年转移发生率分别为7%、13%和26%。对于无转移生存5年的患者，25年转移发生率分别为6%、11%和21%。对于无转移生存10年的患者，25年转移发生率分别为4%、8%和21%。对于小葡萄膜黑色素瘤与中葡萄膜黑色素瘤，通过条件分析，维持无转移生存3年/5年/10年的患者，风险比分别为1.50（P <0.01）/1.53（P <0.01）/1.77（P = 0.01），对于中葡萄膜黑色素瘤与大葡萄膜黑色素瘤，风险比分别为1.45（P <0.01）/1.44（P = 0.03）/1.96（P = 0.06）。
基于肿瘤大小类别（厚度）分为小、中、大对葡萄膜黑色素瘤转移进行长期比较分析表明，大葡萄膜黑色素瘤随着时间推移更有可能发生转移且转移倾向更高。实现无转移生存3年、5年和10年的患者在所有肿瘤大小类别中后续转移风险均显著降低。
