Clinical prognostic factors in patients with posterior uveal malignant melanoma

Article Abstract:

Malignant melanoma is a cancer with a relatively poor prognosis, however, the prognosis can vary markedly depending on the histopathological characteristics of the lesion. Traditionally, when a melanoma was observed in the uvea of the eye (which consists of the choroid, iris, and associated tissues), the entire eye was removed. After removal of the eye, there was no impediment to detailed histopathological examination of the cancerous tissue. However, in the past 20 years, more patients are receiving radiotherapy to the tumor, which allows the conservation of the eye. In such cases, the detailed prognostic information of the histopathological structure of the tumor is not available. It would therefore be beneficial to establish prognostic factors which may be observed by the clinician from outside the eye. The authors examined the cases of 237 patients with melanoma of the uvea to determine what factors might serve as useful prognostic indicators. Of these patients, 140 had been treated with surgical removal of the eye and 97 were treated with radiotherapy. Seven different factors were found to be significant predictors of outcome on univariate analysis. However, the factors which are significant in univariate analysis often turn out to be so closely related to one another that once one is known, the others provide no additional information. In this case, only the largest linear tumor dimension, the location of the anterior tumor margin, and the age of the patient turned out to be significant. The prognostic contribution of the age of the patient, although statistically significant, was minor. The factors which contribute most strongly to the prognosis are, not surprisingly, closely related to histopathological observations which had already been widely recognized as important prognostic factors. (Consumer Summary produced by Reliance Medical Information, Inc.)

Eye cancer

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Are malignant melanoma patients are higher risk for a second cancer

Article Abstract:

About one quarter of all people will develop a cancer during their lifetime. In addition to the obvious medical impact, the great likelihood of cancer also has an impact on epidemiological research as well. The chances are excellent that any one factor may be associated with some cases of cancer. However, before any conclusions are drawn, it must be demonstrated that the association is due to more than chance. It is estimated that from 1.5 to 2.0 percent of patients with malignant melanoma develop second cancers, but it is not clear if this is more than just the results of random chance. This was further investigated in a study of 370 patients with malignant melanoma. A total of 27 patients (7.3 percent) developed a second cancer. In five cases, the cancer developed roughly at the same time (within six months) as the malignant melanoma. In the remaining cases, the second cancer developed within an average of three years after the melanoma. Patients who had developed a different cancer prior to the melanoma were not included in this analysis. Breast cancer was especially common, occurring in nine of the melanoma patients. The number of second cancers in the population of melanoma patients was 4.1 times higher than would be expected in such a group on the basis of chance alone. The risk of breast cancer was 6.6 times higher among the melanoma patients. However, an analysis of the characteristics of the malignant melanoma in these patients identified no features that might indicate why the patients with second cancer might be different from their counterparts who did not develop second cancers. The results of this study suggest that patients with malignant melanoma may have a predisposition to develop cancer, although the nature of this predisposition remains unknown. (Consumer Summary produced by Reliance Medical Information, Inc.)

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