Dados do Trabalho

Título

CLINICAL AND HISTOPATHOLOGICAL PARAMETERS AS PREDICTORS OF LONG-TERM OUTCOME IN UVEAL MELANOMA

Introdução

Uveal melanoma is the most prevalent primary intraocular malignancy in adults. This poorly understood disease might arise from the choroid, iris and ciliary body melanocytes. In the last decades, many advances in local treatment have improved tumor management. However, the systemic control of this cancer still represents a major issue since the knowledge concerning its carcinogenesis and factors related to its unfavorable prognosis is scarce.

Objetivo

This study aimed to analyze clinical and histopathological parameters and their association with long-term outcomes in patients diagnosed with uveal melanoma and treated at a referral center in Brazil.

Método

Demographic and clinical data from a cohort of patients (n=36) who underwent treatment for uveal melanoma at Hospital das Clínicas da UFMG were retrospectively analyzed. A pathologic review was performed to reclassify the disease stage, according to the 8th AJCC TNM edition updates (n=24). Event, defined as tumor recurrence or death from any cause, and event-free survival were also analyzed. Multivariate analysis was performed to identify independently-associated parameters with the event.

Resultado

Patients, diagnosed between 2009 and 2020, were well balanced regarding gender. The mean age was 56.33 years (50.38-62.28) and the great majority had the choroid as single primary site (83.3%). After the pathologic review, 54.2% of patients were reclassified as stage III at diagnosis. The largest basal diameter and thickness were ≥ 10mm in 91.7% and 58.3% of cases, respectively. There was ciliary body invasion in 10 (41.7%) cases and six (25%) patients had more than 50% of epithelioid cells on histology. Analyzing the pathologic review group, event was identified in five (20.8%) patients and event-free survival was 59.4 months (95% CI, 7.2 to 79.2). Variables with p<0.20 in the univariate analysis - age (p=.12), time to treatment initiation (p=.17) and specific pattern of the extracellular matrix (p=0.07) - were analyzed in the multivariate model, but none was independently-associated with the event.

Conclusão

Our findings support the evidence that uveal melanoma is a heterogeneous and life-threatening disease. However, this study did not identify predictors of long-term outcomes, probably due to the small sample size and low event rate. Molecular analysis may add to better understanding of this complex cancer.

Palavras-chave

Uveal melanoma, Choroid melanoma, Ciliary body melanoma