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Patients presenting...
Patients presenting with metastases: stage IV uveal melanoma, an international study
- Article/chapterEnglish2022
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LIBRIS-ID:oai:prod.swepub.kib.ki.se:148304176
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http://kipublications.ki.se/Default.aspx?queryparsed=id:148304176URI
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https://doi.org/10.1136/bjophthalmol-2020-317949DOI
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Language:English
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Summary in:English
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To analyse ocular and systemic findings of patients presenting with systemic metastasis.Methods and analysisIt is an international, multicentre, internet-enabled, registry-based retrospective data analysis. Patients were diagnosed between 2001 and 2011. Data included: primary tumour dimensions, extrascleral extension, ciliary body involvement, American Joint Committee on Cancer (AJCC)-tumour, node, metastasis staging, characteristics of metastases.ResultsOf 3610 patients with uveal melanoma, 69 (1.9%; 95% CI 1.5 to 2.4) presented with clinical metastasis (stage IV). These melanomas originated in the iris, ciliary body and choroid in 4%, 16% and 80% of eyes, respectively. Using eighth edition AJCC, 8 (11%), 20 (29%), 24 (35%), and 17 (25%) belonged to AJCC T-categories T1–T4. Risk of synchronous metastases increased from 0.7% (T1) to 1.5% (T2), 2.6% (T3) and 7.9% (T4). Regional lymph node metastases (N1a) were detected in 9 (13%) patients of whom 6 (67%) had extrascleral extension. Stage of systemic metastases (known for 40 (59%) stage IV patients) revealed 14 (35%), 25 (63%) and 1 (2%) had small (M1a), medium-sized (M1b) and large-sized (M1c) metastases, respectively. Location of metastases in stage IV patients were liver (91%), lung (16%), bone (9%), brain (6%), subcutaneous tissue (4%) and others (5%). Multiple sites of metastases were noted in 24%. Compared with the 98.1% of patients who did not present with metastases, those with synchronous metastases had larger intraocular tumours, more frequent extrascleral extension, ciliary body involvement and thus a higher AJCC T-category.ConclusionsThough higher AJCC T-stage was associated with risk for metastases at diagnosis, even small T1 tumours were stage IV at initial presentation. The liver was the most common site of metastases; however, frequent multiorgan involvement supports initial whole-body staging.
Added entries (persons, corporate bodies, meetings, titles ...)
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Finger, PT
(author)
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Kivela, TT
(author)
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Simpson, ER
(author)
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Gallie, BL
(author)
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Saakyan, S
(author)
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Amiryan, AG
(author)
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Valskiy, V
(author)
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Chin, KJ
(author)
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Semenova, E
(author)
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Seregard, SKarolinska Institutet
(author)
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Fili, MKarolinska Institutet
(author)
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Wilson, M
(author)
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Haik, B
(author)
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Caminal, JM
(author)
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Catala-Mora, J
(author)
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Gutierrez, C
(author)
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Pelayes, DE
(author)
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Folgar, AM
(author)
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Jager, MJ
(author)
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Dogrusoz, M
(author)
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Luyten, GPM
(author)
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Singh, AD
(author)
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Suzuki, S
(author)
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Karolinska Institutet
(creator_code:org_t)
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In:The British journal of ophthalmology: BMJ106:4, s. 510-5171468-20790007-1161
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Garg, G
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Finger, PT
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Kivela, TT
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Simpson, ER
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Gallie, BL
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Saakyan, S
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Amiryan, AG
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Valskiy, V
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Chin, KJ
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Semenova, E
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Seregard, S
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Fili, M
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Wilson, M
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Haik, B
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Caminal, JM
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Catala-Mora, J
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Gutierrez, C
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Pelayes, DE
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Folgar, AM
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Jager, MJ
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Dogrusoz, M
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Luyten, GPM
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Singh, AD
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Suzuki, S
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Karolinska Institutet