Metastatic risk for distinct patterns of postirradiation local recurrence of posterior uveal melanoma

J. W. Harbour, D. H. Char, S. Kroll, J. M. Quivey, J. Castro, E. S. Gragoudas, K. M. Egan

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67 Scopus citations


Objective: The purpose of the study is to compare the prognostic significance of horizontal/marginal versus vertical/diffuse patterns of postirradiation local recurrence of posterior uveal melanoma. Design: The study design was a nonrandomized, retrospective clinical study. Semiparametric and nonparametric statistical techniques were used. Participants: Seven hundred sixty-six posterior uveal melanoma patients were studied. Intervention: Either iodine-125 plaque or helium ion radiation therapy was performed. Main Outcome Measures: Local tumor recurrence and systemic metastasis were measured. Results: Local tumor recurrence was detected in 66 (8.6%) of 766 irradiated tumors. The 5-year actuarial rate of local recurrence was 10%. The recurrence pattern was horizontal/marginal in 27 patients (41%) and vertical/diffuse in 39 patients (59%). Systemic metastasis was detected in 5 patients (19%) with horizontal/marginal recurrence and in 19 patients (49%) with vertical/diffuse recurrence. After known metastatic risk factors were controlled, the relative risk for metastasis was 2.2 for horizontal/marginal recurrence and 5.1 for vertical/diffuse recurrence (P = 0.05). The actuarial rate of systemic metastasis was 2.9% per year for all patients, 6.3% per year for patients with horizontal/marginal recurrence, and 15.5% per year for patients with vertical/diffuse recurrence. Conclusions: Postirradiation local recurrence of posterior uveal melanoma is a risk factor for systemic metastasis. Vertical/diffuse recurrences may be associated more strongly with metastatic disease than horizontal/marginal recurrences.

Original languageEnglish (US)
Pages (from-to)1785-1793
Number of pages9
Issue number11
StatePublished - 1997
Externally publishedYes

ASJC Scopus subject areas

  • Ophthalmology


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