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Endoresection in high posterior choroidal melanomas: long-term outcome
J García-Arumí1, M A Zapata, O Balaguer
1Hospital Vall d'Hebron, Barcelona, Spain.
The British Journal of Ophthalmology
|July 26, 2008
Summary
Endoresection offers a safe and effective treatment for posterior choroidal melanomas, with high rates of eye retention and survival. This surgical approach shows comparable outcomes to other methods, despite the challenges of this specific melanoma type.
Area of Science:
- Ophthalmology
- Oncology
Background:
- Posterior choroidal melanomas often lead to eye enucleation due to radiotherapy complications.
- Endoresection is explored as an alternative treatment to preserve the eye.
Purpose of the Study:
- To evaluate the long-term safety and efficacy of endoresection for posterior choroidal melanomas.
- To assess outcomes including metastasis, survival, local recurrence, visual acuity, and enucleation rates.
Main Methods:
- Retrospective, non-randomized, interventional case series of 38 patients undergoing endoresection.
- Inclusion criteria for primary procedures: tumor thickness ≥8 mm, base <15 mm, not exceeding the equatorial area.
- Salvage endoresection was performed in four patients.
Main Results:
- 92.1% of patients retained their eyes at long-term follow-up (mean 70.63 months).
- 5-year overall survival was 88.2%, and specific survival was 90.9%.
- Local recurrence occurred in two patients before 3 years; metastatic disease in two patients by 5 years.
Conclusions:
- Endoresection demonstrates comparable metastasis, recurrence, and survival rates to other techniques for posterior choroidal melanomas.
- Further research and extended follow-up are necessary due to the unique presentation of these melanomas.