Endoresection technique with/without brachytherapy for management of high posterior choroidal melanoma: Extended follow-up results

Jose Garcia-Arumi, Mahmoud Leila, Miguel Angel Zapata, Daniel Velázquez, M. Carme Dinares-Fernandez, Francesc Tresserra, Borja Corcostegui

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10 Citations (Scopus)

Abstract

Purpose: To evaluate the long-term efficacy and safety of endoresection for high posterior choroidal melanoma. Methods: Retrospective nonrandomized interventional case series. Forty-one patients had endoresection as primary treatment for posterior choroidal melanoma. Of these, 21 patients had adjuvant brachytherapy. The inclusion criteria were tumor thickness ≥8 mm, base diameter <15 mm, and posterior tumors not extending anterior to the equator. Main outcomes measures were enucleation rate, visual outcome, surgical complications, local recurrence, metastasis, and mortality. Results: Mean follow-up time was 102.5 months. Mean preoperative best-corrected visual acuity was 20/100. Mean tumor thickness was 9.8 mm (range, 7.7-13.5 mm; standard deviation, 1.7 mm), mean base diameter was 9.9 mm (range, 5-15 mm; standard deviation, 2.8 mm). At the latest visit, 36 patients (87.8%) still retained the eye. Mean postoperative best-corrected visual acuity was 20/1,625. Retinal detachment was the main postoperative complication (28.9%). At completion of follow-up, 12% of patients had phthisis bulbi, and 3 developed chronic hypotony. Five patients (12.2%) had local tumor recurrence; none of them had received brachytherapy as initial treatment. At 5 years of follow-up, 3 patients (7.3%) had liver metastasis. On Kaplan-Meier analysis at 10 years, all-cause mortality was 7.3% and specific mortality because of melanoma was 2.4%. Conclusion: Endoresection of high posterior melanomas was not associated with a higher risk of metastasis, death, or local recurrence than other reported techniques used to treat similar melanomas.
Original languageEnglish
Pages (from-to)628-637
JournalRetina
Volume35
Issue number4
DOIs
Publication statusPublished - 1 Jan 2015

Keywords

  • ab interno retinochoroidectomy
  • choroidal melanoma
  • endoresection
  • internal resection of uveal melanoma
  • local resection of choroidal melanoma

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