THE SURVIVAL RATE OF PATIENTS FOLLOWING UVEAL MELANOMA EYEBALL REMOVAL IN PERM REGION

Objective  — analysis  of survival  rate   among   the  patients with uveal  melanoma eyeball  removal  in Perm   Region.  patients  and methods. Retrospective  analysis  of medical  documentation of 108 patients treated in ophthalmologic  departments in the  cit y  of Perm  has  been  carried out.  Patients have  undergone the  surgery for uveal melanoma eyeball enucleation (2005–2014).

Results. Analytic period  involved 108 uveal melanoma eyeball removal  in 108 patients aged  17–89 (61,61,6 years  in average). There  were 61 (56,5%) women and 47 (43,5%) men.  Practical blindness  was identified in 63,8% eyes,  and in remaining  eyes it was detected in 0,005–1,0 cases. Melanoma  was localized in choroid in 79,6%; ciliary body — 10,2%; iris — 4,6%; and ciliary body and iris — 5,6%. Histology revealed  mixed cell form  in 68,5% cases; sarcomatoid form  — 28,7%; epithelioid cell form  — 2,8%. The outcome was determined in 99 (91,7%) patients. Follow-up period  was  from 6 months to 10 years  after  enucleation. Among those  27 (27,3%) patients died within the analytic period.  Five-year survival rate  was observed in 79,8% patients with average lifespan 3,4 yrs. Cause  of death  was established in 19 (70,4%) individuals. Association  with oncologic diseases was determined in 6 (31,6%), and non-oncologic in 13 (68,4%) subjects.

Conclusion. At the place of residence life-long observation by ophthalmologist and oncologist  is essential for these patients. Outpatient  physicians should have oncologic alertness while working with patients of any age for early diagnosis  of eye neoplasm.

1. Lutz J.M., Gree I.M., Foss A.J. Risk factors for intraocular melanoma and occupational exposure. Br. J. Ophthalmol. 1999;83(10):1190‑1193.

2. Brovkina A. F., Vаl’skij V. V., Gusev G. A. [Guide for physicians. Ophthalmooncology] M.: Medicina, 2002. (in Russ.).

3. Brovkina A.F., Astahov Ju.S. [Manual of clinical ophthalmology]. M.: Medical information agency, 2014. (in Russ.).

4. Brovkina A.F. [Choroidal melanomas: problems, controversial questions] Sovremennye aspekty lechenija melanom horioidei: problemy i diskussionnye voprosy [Annals of ophthalmology]. Vestnik oftal’mologii. 2006;1:13‑15. (in Russ.).

5. Saakjan S.V., Panteleeva O.G., Shirina T.V. [Metastatic disease characteristics and survival in patients with uveal melanoma depending on primary tumor treatment]. Osobennosti metastaticheskogo porazhenija i vyzhivaemosti bol’nyh s uveal’noj melanomoj v zavisimosti ot provedennogo lechenija [Russian ophthalmological journal]. Rossijskij oftal’mologicheskij zhurnal. 2012;5(2):55‑7 (in Russ.).

6. Merabishvili V., Merabishvili E. [Survival of patients with malignant tumors of the eye taking into account gender, age and histological structure of neoplasms]. Vyzhivaemost’ bol’nyh zlokachestvennymi novoobrazovanijami glaza s uchetom pola, vozrasta i gistologicheskoj struktury opukhole.j [Ophthalmology]. Oftal’mologija in Russia. 2016;13(1):38‑43. (In Russ.). DOI: http://dx.doi.org/10.18008/1816‑5095‑2016‑1

7. Stojuhina A.S., Chesalin I.P. [Survival rates for large choroidal melanomas]. Vyzhivaemost’ bol’nyh bol’shimi melanomami horioidei [Annals of ophthalmology]. Vestnik oftal’mologii. 2014;4:39‑44. (in Russ.). doi: 10.17116/oftalma2015131190‑94

8. Kujala E., Makite T., Kivela T. Very long‑term prognosis of patients with malignant uveal melanoma. Invest. Ophthalmol. Vis.Sci. 2003:44:4651‑4659.

9. Assessment of metastatic disease status at death in 435 patients with large choroidal melanoma in the Collaborative Ocular Melanoma Study (COMS): COMS report. 15. Arch Ophthalmol. 2001;119;670‑6.

10. Gragoudas E.S., Egan K.M., Seddon J.M., et al. Survival of patients with metastases from uveal melanoma. Ophthalmology. 1991;98:383‑9.

11. Amirjan A.G., Saakjan S.V. [Prognostic factors for uveal melanoma]. Faktory prognoza uveal’noj melanomy. [Annals of ophthalmology]. Vestnik oftal’mologii. 2015;1:90‑94. (in Russ.). doi: 10.17116/oftalma2015131190‑94

12. Shhepetneva M.A., Kovalevskaja M.A., Efimova H.A. [Analysis of the incidence of melanoma of the choroid in the Voronezh Region]. Analiz zabolevaemosti melanomoj sosudistoj obolochki v Voronezhskoj oblasti. Sistemnyj analiz i upravlenie v biomedicinskih sistemah: zhurnal prakticheskoj i teoreticheskoj biologii i mediciny. [System analysis and management in biomedical systems: Journal of Practical and Theoretical Biology and Medicine]. 2008;7(3):640‑642. (in Russ.).

13. Furdova A., Slezak P., Chorvath M., Waczulikova I., Sramka M., Kralik G. No differences in outcome between radical surgical treatment (enucleation) and stereotactic radiosurgery in patients with posterior uveal melanoma. Neoplasma. 2010;57(4):377—381. doi:10.4149/neo_2010_04_377