Reduced melanoma-related mortality in uveal melanoma by preenucleation radiotherapy.
BACKGROUND
Radiotherapy of an eye before enucleation, so called preenucleation radiotherapy (PER), of patients with uveal melanoma was initiated to reduce enucleation-induced systemic metastasis. Earlier studies with a short follow-up period have not demonstrated a significant effect on survival.


OBJECTIVE
To study the effect of PER on melanoma-related mortality after more than 9 years of follow-up.


METHODS
In a prospective study, 167 patients with uveal melanoma were treated between 1978 and 1992 by irradiation with 800 rad (8 Gy) given in 2 fractions 2 days before enucleation. A group of 108 patients with uveal melanoma treated between 1971 and 1992 by enucleation only in the same hospital served as a historical control group. Patients were followed up until December 2002 or death.


RESULTS
Melanoma-related death occurred in 32.3% of the PER-treated group and in 40.7% of the enucleation only group. Mean follow-up was 9.25 years. After 48 months of follow-up, a significant difference in survival became evident in favor of the PER group. The estimated 15-year survival rates for patients with melanoma in the PER group and enucleation only group were 63.7% and 51.0%, respectively. For patients dying of all causes, these percentages were 47.5% and 25.2%, respectively. In both groups, women had a better prognostic outcome than men.


CONCLUSIONS
This study suggests that PER improves long-term survival in patients with uveal melanoma.
Kilic
Emine
E
Department of Ophthalmology, Erasmus MC, Rotterdam, the Netherlands.
Stijnen
Theo
T
de Jong
Paulus T V M
PT
Mooy
Cornelia M
CM
Eijkenboom
Wilhelmina M H
WM
Ringens
Peter J
PJ
Luyten
Gre P M
GP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019583:Dose Fractionation, Radiation; D015353:Eye Enucleation / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000532:radiotherapy*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011300:Preoperative Care; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D015996:Survival Rate; D014604:Uveal Neoplasms / Q000401:mortality* / Q000532:radiotherapy*