Prognosis in uveal melanoma with extrascleral extension
J. C. Affeldt, D. S. Minckler, S. P. Azen and L. Yeh
Two thirds of 60 patients followed up after enucleation for uveal melanoma
with extrascleral extension eventually died of metastatic disease. Large
intraocular tumor size, more malignant cell types, optic nerve invasion,
and surgical transection or nonencapsulation of the extraocular tumor
margin were found to be significantly correlated with development of
metastases. Advanced age at enucleation and large intraocular tumor size
were significantly associated with early metastatic death. Recurrence of
tumor in the orbit was identified in 10% of the patients and was
significantly correlated with large intraocular tumor size and optic nerve
invasion. Early exenteration, performed in seven cases, did not improve
prognosis. Application of Bayesian methods produced a multifactorial model
for prediction of metastatic disease within 13 years after enucleation.
