title: Endoresection versus iodine-125 plaque brachytherapy for the treatment of choroidal melanoma.
abstract: OBJECTIVE
  To compare the effectiveness of pars plana vitrectomy endoresection with iodine-125 brachytherapy in the treatment of choroidal melanoma.
  
  
  METHODS
  A nested case-control study (1:2) from a surgical cohort.
  
  
  METHODS
  The study comprised 81 choroidal melanoma patients treated with either endoresection or iodine-125 brachytherapy. Twenty-seven patients who had undergone endoresection were matched according to tumor height and postequatorial tumor location with 54 cases treated with iodine-125 brachytherapy. Metastatic disease, overall survival, local tumor recurrence, visual acuity, and secondary enucleation rates were analyzed and compared between groups.
  
  
  RESULTS
  Metastatic spread was observed in 11 patients in the iodine-125 brachytherapy group vs only 1 patient in the endoresection group (20.4% and 3.7%, respectively, P = .053). Fourteen patients died during follow-up: 11 in the brachytherapy arm vs 3 in the endoresection arm (20.4% and 11.1%, respectively, P = .238). For the iodine-125 brachytherapy and endoresection groups, respectively, the 5-year Kaplan-Meier estimates were as follows: overall survival, 81.5% vs 89.2% (log-rank test, P = .429;); relapse-free survival, 96.6% vs 92.4% (P = .2); visual acuity retention equal or superior to 20/200, 66.4% vs 59.9% (P = .083), and eye retention, 85.7% vs 87.8% (P = .942).
  
  
  CONCLUSIONS
  Endoresection for choroidal melanoma is an effective treatment modality in selected cases of posterior choroidal melanomas, with outcomes similar to those obtained with iodine-125 brachytherapy.
authors.affiliation: Ophthalmology Department, University Hospital of Bellvitge, Barcelona, Spain. jmcaminal@gmail.com
authors.forename: Josep M
authors.initials: JM
authors.lastname: Caminal
authors.forename: Karol
authors.initials: K
authors.lastname: Mejia
authors.forename: Cristina
authors.initials: C
authors.lastname: Masuet-Aumatell
authors.forename: Lluis
authors.initials: L
authors.lastname: Arias
authors.forename: Josep M
authors.initials: JM
authors.lastname: Piulats
authors.forename: Cristina
authors.initials: C
authors.lastname: Gutierrez
authors.forename: Joan
authors.initials: J
authors.lastname: Pera
authors.forename: Jaume
authors.initials: J
authors.lastname: Catala
authors.forename: Marc
authors.initials: M
authors.lastname: Rubio
authors.forename: Jordi
authors.initials: J
authors.lastname: Arruga
mesh_terms: D001918:Brachytherapy; D016022:Case-Control Studies; D002830:Choroid Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D015353:Eye Enucleation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D013508:Ophthalmologic Surgical Procedures; D011879:Radiotherapy Dosage; D015996:Survival Rate; D016896:Treatment Outcome; D014792:Visual Acuity
chemical_list: D007457:Iodine Radioisotopes