Answer
In a prospective cohort study of 3072 patients with choroidal melanoma, researchers found that, for some patients, early treatment, rather than watchful waiting, might better prevent metastatic death. [7, 8]
For the study, researchers correlated age at death, cause of death, age at treatment, and survival predictors. Tumors ranged in size from 2.4 to 23.8 mm in basal diameter and from 0.6 to 18.3 mm in thickness, and the largest basal diameter correlated with all survival predictors except chromosome 6p gain. Older age at treatment was correlated with largest basal tumor diameter, tumor thickness, TNM stage, ciliary body involvement, extraocular spread, chromosome 3 loss, and chromosome 8q gain. A total of 1005 patients died by the end of the study, and 561 of these patients died from metastatic disease from uveal melanoma. Median age at death was lower (68.6 years) for patients who died from metastatic melanoma than for patients who died from any cause (74.0 years). None of the survival predictors correlated with age at death among the patients who died of metastasis except for mitotic count, which had a weak correlation. [7, 8]
-
Color photograph of a dome-shaped choroidal melanoma.
-
Early fluorescein angiogram of choroidal melanoma showing intrinsic vascularity.
-
Late fluorescein angiogram of choroidal melanoma showing early diffuse staining.
-
B-scan ultrasound showing acoustic hollowing and uveal excavation in posterior choroidal melanoma.
-
A-scan ultrasound of choroidal melanoma showing low-to-medium internal reflectivity.
-
B-scan ultrasound showing acoustic hollowing in intraorbital extension of a posterior choroidal melanoma.
-
T2-weighted MRI showing a small anterior choroidal melanoma in the left eye.
-
Transpupillary photograph showing a posterior choroidal melanoma.
-
Photograph showing an enucleated eye with advanced choroidal melanoma with transscleral extension.
-
Histologic section of an enucleated eye showing a large dome-shaped choroidal melanoma.
-
Histologic section of an enucleated eye showing a medium-sized mushroom-shaped choroidal melanoma with associated exudative retinal detachment.
-
Choroidal melanoma. Histologic section showing spindle A cells in a uveal nevus.
-
Choroidal melanoma. Histologic section showing spindle B cells in a uveal melanoma.
-
Choroidal melanoma. Histologic section showing epithelioid cells in a uveal melanoma.
-
Photograph showing a skin metastasis of a posterior choroidal melanoma.
-
Intraoperative photograph showing placement of a radioactive plaque for posterior choroidal melanoma.
