Program Book

1617 Ump116
INCIDENCE OF METASTATIC DISEASE AND
SURVIVAL OF 716 CONSECUTIVE PATIENTS WITH
POSTERIOR UVEAL MELANOMA : A RETROSPECTIVE
MONOCENTRIC REVIEW
Fatima Hammouch1, Patrick De Potter2, David Francart3, François
Dall’Armellina4, Jean-François Baurain5 (fatima.hammouch@uclouvain.be)
1. Oncology Department, Centre du Cancer, Cliniques Universitaires
Saint-Luc, Université Catholique de Louvain ; 2. Ophtalmology
Department, Centre du Cancer, Cliniques Universitaires Saint-Luc; 3.
Ophtalmology Department, Centre du Cancer, Cliniques Universitaires
Saint-Luc ; 4. Oncology Department, Centre du Cancer, Cliniques
Universitaires Saint-Luc, Université Catholique de Louvain ; 5.
Oncology Department, Centre du Cancer, Cliniques Universitaires
Saint-Luc, Université Catholique de Louvain, Brussels.
Purpose. To determine the rate, time and location of systemic
metastases in patients with posterior uveal melanoma and to evaluate
risk factors and survival after diagnosis of systemic relapse.
Methods. A retrospective review was performed on 716 consecutive
patients, referred and managed at the Centre du Cancer, Brussels,
for posterior uveal melanoma, between January 1998 and December
2010. Data were analyzed with SPSS 18 for Mac. The rate of metastatic
disease was calculated and patients survival was assessed by Kaplan-
Meier method. The impact of metastatic diesase–related symptoms
on survival was analyzed by the Log-Rank test. A multivariate Cox
regression was performed to identify risk factors for metastatic
disease.
Results. The median age at diagnosis was 63 years. According to the
COMS classification, there were 43 (6%) small tumors, 379 (53%)
medium tumors, 232 (32%) large tumors and 62 (9%) tumors were
unclassified. The treatment consisted in enucleation, radiotherapy
+/- thermotherapy and thermotherapy alone in 24%, 66% and 10% of
patients, respectively. The median time between tumor diagnosis and
treatment was 9 days. The median time of follow up for the 716 patients
was 3 years. Among them, 100 patients (14%) developed metastatic
disease (71% exclusively liver localisation, 19% extraliver and liver
localisations and 5% only extraliver localisation) with a median time
to relapse of 32 months. The relapse free survival from diagnosis at 5
and 10 years was 81% and 75%, respectively. Risk factors for systemic
metastases (multivariate analysis) were: large tumor (p=0.035),
epitheloid cell melanoma (p=0.002) and later age at diagnosis
(p=0.002). The median follow-up from relapse was 34 months. Fourty
patients (40%) died from their melanoma with a median survival time
of 17 months. No difference in survival was observed between those
patients with metastasis-related symptoms and those without (p>
0.05).
Conclusions. Even with a relatively short follow-up time (36 months),
our study showed a lower rate (14%) of metastatic disease with a
higher median survival time than those previously reported. Our
cohort seemed to be homogeneous, with classical risk factors
identified. While the issue of regular systemic screening on patient
survival was not assessed, we did not find a significant difference
between asymptomatic and systemic metastasis-related symptomatic
patients. The potential impact of the treatment(s) on prognosis among
our patients with metastatic disease is under investigation.
Financial disclosure. None
UVEAL MELANOMA
Posters
113
25 Ump117
LONG LASTING SURVIVAL OF UVEAL MELANOMA
WITH EXTRAOCULAR EXTENSION
Ignacio Zeolite, Carlos Zeolite, Juan Oscar Croxatto (izeolite@yahoo.
com)
Oftar Mendoza, Universidad de Mendoza
Purpose. To report a long term survival (over 60 months) of a patient
with malignant melanoma with extraocular extension post diagnostic
FNAB with no concomitant brachytherapy.
Methods. A 80-year old female patient with malignant melanoma with
extraocular extension post FNAB with no coadyuvant brachitherapy was
treated with excisional biopsy of subconjunctival dark clumps diagnosed
as extraocular extension of uveal melanoma. She refused any choice of
treatment and was followed in a regular basis for 41 months.
Results. Survival after FNAB with the diagnosis of malignant uveal
melanoma was 51 months (46 months with extraocular extension). In this
case we present an unusual pattern of extraoclar extension as multiple
subconjunctival clumps with realatively long term stability while the
general health status of the patient was well. At the time of the declining
of the general health status the tumors grew fast and the patient died in
2 months with liver metastases. Enucleation was performed 50 months
after FNAB because of ocular infection and tumor necrosis. No other
choice of treatment was authorized for the patient nor the family.
Conclusions. Malignant melanoma of the choroid can spread
extraocularly after FNAB.
Co-adyuvant brachitherapy is indicated after FNAB. Different patterns of
extraocular extension can be observed.
Long-term stability of the lesion can be associeted with good general
health status.
Financial disclosure. None
2133 Ump118
CLINICOPATHOLOGIC CORRELATIONS OF PLAQUE
BRACHYTHERAPY FAILURE IN THE TREATMENT OF
CHOROIDAL MELANOMA
Jill R. Wells, Chris S. Bergstrom, Qing Zhang, Hans E. Grossniklaus
(jrwells14@hotmail.com)
Emory Eye Center, Oncology and Pathology Service
Purpose. To correlate the histopathologic findings in the enucleated
eyes of three patients who failed treatment for choroidal melanoma with
plaque brachytherapy.
Methods. Three patients who had undergone enucleation for failure
of plaque brachytherapy for choroidal melanoma were identified.
The clinical and histopathologic features of the enucleated eyes were
reviewed as well as immunohistochemical staining.
Results. Based on the clinicopathologic correlations, case 1 failed
secondary to inadequate radiation to the peripheral tumor; case 2 failed
secondary to inadequate radiation to the tumor over the nerve; and case
3 failed secondary to inherent radioresistance of the tumor.
Conclusions. Careful attention to tumor ultrasound measurements and
correct plaque design is important. Tumors overhanging the optic nerve
are the difficult to treat. Further studies are needed to determine if and
which cellular and genetic factors in choroidal melanomas underlie
radioresistant cellular phenotypes.
Financial disclosure. None