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TitreLong-term results of primary transpupillary thermotherapy of posterior uveal melanoma in 88 consecutive cases
ButTo evaluate long term ocular and systemic outcomes after primary transpupillary thermotherapy (TTT) for posterior choroidal melanoma.
MéthodesNoncomparative interventional case series wit 88 patients newly diagnosed selected posterior choroidal melanoma. All tumors had either documentation of growth or substantial clinical risks factors for future growth.
RésultatsThe mean tumor size before treatment was 7.1 mm in base and 2.9 mm in thickness. 30 tumors (34%) were touching the optic disc. After a mean follow-up of 90 months and an average of 3 TTT sessions, tumor recurrence was found in 28 eyes (32%) with an intraocular location in 24 cases (27%) and an extrascleral location in 4 cases (5%). Other complications included branch retinal vein and/or artery occlusion in 31 eyes (35%), retinal neovascularisation in 8 eyes (9%), and vitreous hemorrhage in 9 eyes (10%). Late enucleation was performed in 5 patients (6%) at a mean interval of 84 months as management of tumor recurrence and melanoma-specific metastatic disease developed in 4 patients (5%) at a mean interval of 68 months. The only risk factor for tumor recurrence was a total number of TTT sessions greater than 3 sessions (P=0,02). The risk factors for vascular occlusion were the proximity to the disc (P=0,04) and to fovea (P=0.09). Greater tumor thickness was the most significant factor predictive of retinal neovascularisation (P=0,05). Kaplan Meier estimates revealed that 2% showed intraocular recurrence at 1 year, 20% at 3 years, 25% at 5 years and 27% at 7 years follow-up.
ConclusionOur results showed the increasing number of tumor recurrence and vascular complications with long-term observation. Tumors that required more than 3 sessions of TTT are more likely to develop recurrence.
Auteur 1
NomDE POTTER
InitialesP
InstitutOcular Oncology Unit
VilleBrussels
Auteur 2
NomJamart
InitialesJ
Auteur 3
NomDe Clercq
InitialesC
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