Weinhaus R S, Seddon J M, Albert D M, Gragoudas E S, Robinson N
Arch Ophthalmol. 1985 Nov;103(11):1673-7. doi: 10.1001/archopht.1985.01050110067027.
We reviewed 242 cases of choroidal and ciliary body melanoma that were treated by enucleation to determine the importance of juxtapapillary location as a prognostic factor for tumor-related deaths. Analysis involved Kaplan-Meier survival curves and Cox proportional hazards analysis. Patients with juxtapapillary tumors had a worse prognosis than those with tumors in other locations (64% vs 78% five-year survival), but the difference was not statistically significant. Juxtapapillary location was not an independent risk factor on Cox multivariate analysis. Risk factors included number of epithelioid cells per high-power field, largest tumor dimension, location of the tumor's anterior margin, and invasion to the line of transection. In 63 cases (26%), the tumor was in contact with the optic disc. For these juxtapapillary tumors, we also evaluated the prognostic importance of six variables relevant to juxtapapillary location. On univariate analysis, tumor height at the disc margin, subarachnoid space invasion, and postlaminar optic nerve invasion were significantly related to survival, while disc compression by tumor, prelaminar optic nerve invasion, and extent of disc perimeter surrounded by tumor were not. On Cox multivariate analysis, however, none of these six variables was an independent risk factor. Risk factors for juxtapapillary tumors included number of epithelioid cells per high-power field and location of the tumor's anterior margin.
我们回顾了242例因眼球摘除术治疗的脉络膜和睫状体黑色素瘤病例，以确定视乳头旁位置作为肿瘤相关死亡预后因素的重要性。分析采用Kaplan-Meier生存曲线和Cox比例风险分析。视乳头旁肿瘤患者的预后比其他位置肿瘤患者差（五年生存率分别为64%和78%），但差异无统计学意义。在Cox多因素分析中，视乳头旁位置不是独立的危险因素。危险因素包括每高倍视野的上皮样细胞数量、肿瘤最大直径、肿瘤前缘位置以及对横断线的侵犯。63例（26%）肿瘤与视盘接触。对于这些视乳头旁肿瘤，我们还评估了与视乳头旁位置相关的六个变量的预后重要性。单因素分析中，视盘边缘肿瘤高度、蛛网膜下腔侵犯和视乳头后段视神经侵犯与生存显著相关，而肿瘤对视盘的压迫、视乳头前段视神经侵犯以及肿瘤环绕视盘周长范围则不然。然而，在Cox多因素分析中，这六个变量均不是独立危险因素。视乳头旁肿瘤的危险因素包括每高倍视野的上皮样细胞数量和肿瘤前缘位置。
