title: Uveal melanoma: molecular pattern, clinical features, and radiation response.
abstract: OBJECTIVE
  To characterize the clinical spectrum of class 1 and class 2 uveal melanomas and their relationship with intraocular proton radiation response.
  
  
  METHODS
  Masked retrospective case series of uveal melanoma patients with fine needle biopsy-based molecular profiles.
  
  
  METHODS
  A total of 197 uveal melanoma patients from a single institution were analyzed for pathology, clinical characteristics, and response to radiation therapy.
  
  
  RESULTS
  A total of 126 patients (64%) had class 1 tumors and 71 (36%) had class 2 tumors. Patients with class 2 tumors had more advanced age (mean: 64 years vs 57 years; P = .001), had thicker initial mean ultrasound measurements (7.4 mm vs 5.9 mm; P = .0007), and were more likely to have epithelioid or mixed cells on cytopathology (66% vs 38%; P = .0004). Although mean pretreatment and posttreatment ultrasound thicknesses were significantly different between class 1 and class 2 tumors, there was no difference in the mean change in thickness 24 months after radiation therapy (mean difference: class 1 = -1.64 mm, class 2 = -1.47; P = .47) or in the overall rate of thickness change (slope: P = .64). Class 2 tumors were more likely to metastasize and cause death than class 1 tumors (DSS: P < .0001).
  
  
  CONCLUSIONS
  At the time of radiation therapy, thicker tumors, epithelioid pathology, and older patient age are significantly related to class 2 tumors, and class 2 tumors result in higher tumor-related mortality. We found no definitive clinical marker for differentiating class 1 and class 2 tumors.
authors.affiliation: California Pacific Medical Center, San Francisco, California, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Chappell
authors.forename: Devron H
authors.initials: DH
authors.lastname: Char
authors.forename: Tia B
authors.initials: TB
authors.lastname: Cole
authors.forename: J William
authors.initials: JW
authors.lastname: Harbour
authors.forename: Kavita
authors.initials: K
authors.lastname: Mishra
authors.forename: Vivian K
authors.initials: VK
authors.lastname: Weinberg
authors.forename: Theodore L
authors.initials: TL
authors.lastname: Phillips
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D005451:Fluorescein Angiography; D020869:Gene Expression Profiling; D006801:Humans; D008297:Male; D008545:Melanoma / Q000235:genetics / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011522:Protons; D011882:Radiotherapy, High-Energy; D012189:Retrospective Studies; D014604:Uveal Neoplasms / Q000235:genetics / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy*; D055815:Young Adult
chemical_list: D004273:DNA, Neoplasm; D011522:Protons