Wydanie 4/2006

Ocena odległych wyników leczenia czerniaków naczyniówki metodą resekcji miejscowej

The Evaluation of Choroidal Melanoma Long-Term Treatment Results in Patients Treated with the Local Resection

Iwona Rospond-Kubiak, Krystyna Pecold, Jarosław Kocięcki, Katarzyna Manyś-Kubacka

Katedra i Klinika Okulistyki Akademii Medycznej w Poznaniu Kierownik: dr hab. n. med. Jarosław Kocięcki

Summary: The aim of this study is to present a long-term results and late complications in a group of patients treated with trans-scleral local resection due to choroidal melanoma at the Department of Ophthalmology, Medical University of Poznań, Poland, between 2000-2005.
Patients and method: the studied group comprised 16 eyes of 16 patients (7 women, 9 men, aged 24 to 77 years, mean age 52.25 years). The maximum height measured in US was 6.22-13.63 mm (mean 9.44), basal diameter 8.30-20.73 mm (mean 12.82). The anterior tumor margin was situated anteriorly to the equator in 3 cases, behind the equator in 13 cases. The follow-up period varied from 6 months to 7 years. All patients were operated according to the technique described in details by Foulds and Damato, in each case we performed the adjunctive brachytherapy (ruthenium plaque) during next 24-48 hours; the surgery was conducted in hypotensive general anaesthesia.
Results: a good tumor control was obtained in 11 cases. In 3 cases we were obliged to perform an enucleation due to the local recurrence, in one case – because of painful blind eye, in another one – due to persistent subchoroidal haemorrhages. In our group 4 patients died because of metastatic melanoma. 2 patients had a secondary cataract operated, 1 patient – cataract and retinal detachment.
Conclusions: Transcleral local resection is a treatment option in cases of tumors that would otherwise not be qualified for the globe retaining therapy. The tumor localization in the upper quadrants, large basal diameter (above 16.0 mm), epithelioid/mixed cell type and advanced patient age at the time of surgery worsen the general prognosis as to metastatic melanoma.

Keywords: trans-scleral local resection, choroidal melanoma.