title: Local recurrence after uveal melanoma proton beam therapy: recurrence types and prognostic consequences.
abstract: OBJECTIVE
  To study the prognosis of the different types of uveal melanoma recurrences treated by proton beam therapy (PBT).
  
  
  METHODS
  This retrospective study analyzed 61 cases of uveal melanoma local recurrences on a total of 1102 patients treated by PBT between June 1991 and December 2010. Survival rates have been determined by using Kaplan-Meier curves. Prognostic factors have been evaluated by using log-rank test or Cox model.
  
  
  RESULTS
  Our local recurrence rate was 6.1% at 5 years. These recurrences were divided into 25 patients with marginal recurrences, 18 global recurrences, 12 distant recurrences, and 6 extrascleral extensions. Five factors have been identified as statistically significant risk factors of local recurrence in the univariate analysis: large tumoral diameter, small tumoral volume, low ratio of tumoral volume over eyeball volume, iris root involvement, and safety margin inferior to 1 mm. In the local recurrence-free population, the overall survival rate was 68.7% at 10 years and the specific survival rate was 83.6% at 10 years. In the local recurrence population, the overall survival rate was 43.1% at 10 years and the specific survival rate was 55% at 10 years. The multivariate analysis of death risk factors has shown a better prognosis for marginal recurrences.
  
  
  CONCLUSIONS
  Survival rate of marginal recurrences is superior to that of the other recurrences. The type of recurrence is a clinical prognostic value to take into account. The influence of local recurrence retreatment by proton beam therapy should be evaluated by novel studies.
authors.affiliation: Department of Ophthalmology, Saint Roch Hospital, Nice Teaching Hospital, Nice, France. ncaujolle@aol.com
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Caujolle
authors.forename: Vincent
authors.initials: V
authors.lastname: Paoli
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Chamorey
authors.forename: Celia
authors.initials: C
authors.lastname: Maschi
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Baillif
authors.forename: Joël
authors.initials: J
authors.lastname: Herault
authors.forename: Pierre
authors.initials: P
authors.lastname: Gastaud
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Hannoun-Levi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D016016:Proportional Hazards Models; D061766:Proton Therapy; D012189:Retrospective Studies; D015996:Survival Rate; D047368:Tumor Burden; D014604:Uveal Neoplasms / Q000453:epidemiology / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D055815:Young Adult; D000098943:Uveal Melanoma