title: Endoresection technique with/without brachytherapy for management of high posterior choroidal melanoma: extended follow-up results.
abstract: OBJECTIVE
  To evaluate the long-term efficacy and safety of endoresection for high posterior choroidal melanoma.
  
  
  METHODS
  Retrospective nonrandomized interventional case series. Forty-one patients had endoresection as primary treatment for posterior choroidal melanoma. Of these, 21 patients had adjuvant brachytherapy. The inclusion criteria were tumor thickness ≥8 mm, base diameter <15 mm, and posterior tumors not extending anterior to the equator. Main outcomes measures were enucleation rate, visual outcome, surgical complications, local recurrence, metastasis, and mortality.
  
  
  RESULTS
  Mean follow-up time was 102.5 months. Mean preoperative best-corrected visual acuity was 20/100. Mean tumor thickness was 9.8 mm (range, 7.7-13.5 mm; standard deviation, 1.7 mm), mean base diameter was 9.9 mm (range, 5-15 mm; standard deviation, 2.8 mm). At the latest visit, 36 patients (87.8%) still retained the eye. Mean postoperative best-corrected visual acuity was 20/1,625. Retinal detachment was the main postoperative complication (28.9%). At completion of follow-up, 12% of patients had phthisis bulbi, and 3 developed chronic hypotony. Five patients (12.2%) had local tumor recurrence; none of them had received brachytherapy as initial treatment. At 5 years of follow-up, 3 patients (7.3%) had liver metastasis. On Kaplan-Meier analysis at 10 years, all-cause mortality was 7.3% and specific mortality because of melanoma was 2.4%.
  
  
  CONCLUSIONS
  Endoresection of high posterior melanomas was not associated with a higher risk of metastasis, death, or local recurrence than other reported techniques used to treat similar melanomas.
authors.affiliation: *Retina Department, Vall d'Hebron Hospital, Autónoma University of Barcelona, Barcelona, Spain; †Retina Department, Institute of Ocular Microsurgery (IMO), Barcelona, Spain; and ‡Retina Department, Research Institute of Ophthalmology, Giza, Egypt.
authors.forename: Jose
authors.initials: J
authors.lastname: Garcia-Arumi
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Leila
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Zapata
authors.forename: Daniel
authors.initials: D
authors.lastname: Velázquez
authors.forename: M Carme
authors.initials: MC
authors.lastname: Dinares-Fernandez
authors.forename: Francesc
authors.initials: F
authors.lastname: Tresserra
authors.forename: Borja
authors.initials: B
authors.lastname: Corcostegui
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002830:Choroid Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017075:Laser Coagulation; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D013508:Ophthalmologic Surgical Procedures; D011183:Postoperative Complications; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012429:Ruthenium Radioisotopes / Q000627:therapeutic use; D014792:Visual Acuity / Q000502:physiology
chemical_list: D012429:Ruthenium Radioisotopes