title: Prognostic implications of cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy.
abstract: OBJECTIVE
  Determine whether cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy (FNAB) is a significant prognostic factor for death from metastasis.
  
  
  METHODS
  Retrospective analysis of cases of clinically diagnosed uveal melanoma evaluated by fine-needle aspiration biopsy from 1980 to 2006. Main outcome evaluated was death from metastasis. Associations between baseline clinical variables and cytopathologic classification were evaluated using cross-tabulation. Prognostic significance of cytopathologic classification was evaluated by Kaplan-Meier and Cox proportional hazards analysis.
  
  
  RESULTS
  Of 302 studied biopsies, 260 (86.1%) yielded sufficient cells for cytopathologic classification. Eighty of the 260 patients who had a sufficient specimen have already died (P=0.021), 69 from metastatic uveal melanoma. Cell type assigned by cytopathology was strongly associated with metastasis/metastatic death in this series (P=0.0048). Multivariate analysis showed cytopathologic classification to be an independently significant prognostic factor for metastatic death (P=0.0006). None of the 42 patients whose tumor yielded insufficient aspirates (sampled in at least two sites) have developed metastasis or died of metastasis thus far.
  
  
  CONCLUSIONS
  In this series, cytopathology of fine-needle aspiration biopsy samples obtained from uveal melanomas was strongly prognostic of death from metastasis. Insufficiently aspirates (2 or more sites sampled) proved to be prognostic of a favorable outcome (i.e., not developing metastasis).
authors.affiliation: Department of Ophthalmology, University of Cincinnati, Cincinnati, Ohio, USA.
authors.forename: James Jay
authors.initials: JJ
authors.lastname: Augsburger
authors.forename: Zélia Maria
authors.initials: ZM
authors.lastname: Corrêa
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Trichopoulos
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D001938:Brazil / Q000453:epidemiology; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D014602:Uvea / Q000473:pathology*; D014604:Uveal Neoplasms / Q000401:mortality / Q000473:pathology*; D000098943:Uveal Melanoma