Table 2.
Summary of descriptive case series of partial lamellar sclerouvectomy for uveal melanoma.
| Author | Patients, n | Diameter, mm |
Thickness, mm | Follow-Up, mean | Mortality/Survival | Enucleation | Recurrence | VA, Pre-Treatment | VA, Post-Treatment | Complications/BT | Adjuvant Treatment |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Peyman et al., 1984 [7] | 34 | Mean, 5.3 years (range, 1 to 10 years) | 6% (2 pts died due to mets) | 11 (32.3%) | 14.7% (5 pts) incomplete resection | Postoperative VA ranged from 20/30 to light perception. Ten cases had VA > 20/200 (33%) | Most common operative complication: vitreous hemorrhage. Tractional RD occurred in 10 cases, 5 of which were inoperable, leading to phthisis bulbi and enucleation, cataract formation (9 pts), preretinal membranes, macular pucker, and chronic cystoid macular edema (4 pts). |
No BT. | |||
| Foulds et al., 1986 [8] | 140 | Tumours up to 15 mm | 9% (12 pts) 5-year survival 84% |
Overall: 18% Recurrence 8.5% |
14% 8.5% (12 pts) 1 orbital recurrence first cases |
60% retained useful vision and 25% good vision | Not reported | No BT. | |||
| Shields et al., 1991 [9] | 95 | Mean 8.4 (range, 3.0 to 16.0) | Range, 2.0 to 12.0 (mean, 6.5) | Mean, 5.0 years; Median, 2.5 years (Range, 0.5 to 15.0 years) | 5% mets (5 pts) | 15 pts (16%) |
15 pts (16%) |
23 cases (24%) VA was ≥preoperative VA | VH 83%, intraretinal o subretinal hemorrhage 35% (most resolved spontaneously) RD: 28% Cataract: 34% RD surgery: 17% |
No BT | |
| Damato et al., 1996 [10] | 332 | 13.2 (SD: 4.1) | 7.4 (SD, 3.0) | Median: 36 m (Range, 42 days–20.9 years) |
5-year mortality rates for pts with largest basal tumour diameters of <11 mm, 11–15 mm, and >15 mm: 3%, 20%, and 44%, respectively. |
Adjuvant BT in 50 pts (15%) | |||||
| Damato et al., 2006 [11] | 344 | Median 13 (range, 4 to 21.0) | Median 8 (range, 1.5 to 16.5) | Median: 13.0 years | 16-year metastatic mortality was 20.2% if no risk factors *, 32.5% with one risk factor, and 46.7% with 2 risk factors. |
8 y actuarial rates of eye preservation ranged from 57.1% (>1 ocular risk factor) to 81% for no risk factors *** | 8-year actuarial rates of local tumour control were 75.2% in the absence of any risk factors **, 71.2% with one risk factor, and 47.1% with ≥1 risk factor |
20/17–20/40 in 59.3%, 20/50–20/200 in 28.5%, counting fingers in 8.7%, and hand movements to light perception in 3.5% | 8-year actuarial rates of conservation of vision of counting fingers or better were 63.9% if no risk factors *** were present, 60.1% with one risk factor, and 43.5% with more than one risk factor | RD tended to occur in the early postoperative period. The 2-year actuarial rate of RD was 16.6% (if the tumour height was <6 mm, increasing to 34.0% if the tumour was >9 mm). | Adjuvant BT: 129 pts (37.5%) |
| Bechrakis et al., 2010 [12] | 150 included over 210 | Median 14.5 (SD: 3.1) (range, 6.0–22.5) |
Median 9.4 (SD: 2.0); (range, 2.0–14.6 |
Median 45.5 (SD 31.6) 3–142 months |
5- and 10-year metastatic rates were 28% and 44%, respectively. Significant risk factors were extraocular spread, tumour thickness, and local tumour recurrence |
9 pts (6%) |
Residual tumour: 6%; Recurrence: 26 pts (17.3%); 5 and 10 year recurrence rates: 24% and 32%. Significant risk factors: older age, large basal diameter, lack of adjuvant ruthenium brachytherapy, and RD. |
Not reported | No reported complications | Adjuvant BT in 136 pts (90.6%) |
Abbreviations: BT, brachytherapy; VA, visual acuity; SD, standard deviation; mets, metastases; RD, retinal detachment; VH, vitreous haemorrhage; PLSU, partial lamellar sclerouvectomy; pts, patients. * Risk of metastatic death was categorised according to (1) basal tumour diameter > 15.4 mm; (2) tumour extension anterior to ora serrata; and (3) presence of epithelioid cells. ** Risk of local tumour recurrence was categorised in a similar fashion according to (1) basal tumour diameter > 15.4 mm; (2) posterior tumour extension to within 3.0 mm of optic disk or fovea; and (3) presence of epithelioid cells. *** Risk of adverse ocular outcomes was categorised according to the number of the following features: (1) basal diameter > 15.4 mm; (2) thickness > 8.4 mm; and (3) posterior extension to within 3.0 mm of the optic disk or fovea.