Materiały źródłowe

• #1 Uveal melanoma: Estimating prognosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4399142/

  Uveal melanoma is the most common primary malignant tumor of the eye in adults, predominantly found in Caucasians. Local tumor control of uveal melanoma is excellent, yet this malignancy is associated with relatively high mortality secondary to metastasis. Various clinical, histopathological, cytogenetic features and gene expression features help in estimating the prognosis of uveal melanoma. The clinical features associated with poor prognosis in patients with uveal melanoma include older age at presentation, male gender, larger tumor basal diameter and thickness, ciliary body location, diffuse tumor configuration, association with ocular/oculodermal melanocytosis, extraocular tumor extension, and advanced tumor staging by American Joint Committee on Cancer classification. Histopathological features suggestive of poor prognosis include epithelioid cell type, high mitotic activity, higher values of mean diameter of ten largest nucleoli, higher microvascular density, extravascular matrix patterns, tumor-infiltrating lymphocytes, tumor-infiltrating macrophages, higher expression of insulin-like growth factor-1 receptor, and higher expression of human leukocyte antigen Class I and II. Monosomy 3, 1p loss, 6q loss, and 8q and those classified as Class II by gene expression are predictive of poor prognosis of uveal melanoma.

• #1 Prognosis and survival for eye cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/eye/prognosis-and-survival

  If you have eye cancer, you may have questions about your prognosis. A prognosis is the doctors best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many factors. Only a doctor familiar with your medical history, the type, stage and characteristics of your cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis. […] Stage is an important prognostic factor for eye cancer. A lower stage eye cancer has a better prognosis. […] The location of the eye cancer helps to predict a prognosis. […] A melanoma of the iris often has a better prognosis than a melanoma of the choroid or ciliary body. […] Melanoma that starts to grow in other parts of the eye and spreads (metastasizes) to the ciliary body also has a poorer prognosis.

• #1 Eye Cancer Survival Rates | American Cancer Society

  https://www.cancer.org/cancer/types/eye-cancer/detection-diagnosis-staging/survival-rates.html

  Survival rates can give you an idea of what percentage of people with the same type and stage of cancer are still alive a certain amount of time (usually 5 years) after they were diagnosed. […] Keep in mind that survival rates are estimates and are often based on previous outcomes of large numbers of people who had a specific cancer, but they cant predict what will happen in any persons case. […] These numbers apply only to the stage of the cancer when it is first diagnosed. They do not apply later on if the cancer grows, spreads, or comes back after treatment. […] People now being diagnosed with eye cancer may have a better outlook than these numbers show. Treatments have improved over time, and these numbers are based on people who were diagnosed and treated at least 5 years earlier.

• #1 Prognosis and survival for eye cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/eye/prognosis-and-survival

  People whose tumours have certain gene mutations or too many copies (called overexpression) of certain genes tend to have a poorer outcome. […] Gene expression profiling can help predict the risk of cancer spreading in people with uveal melanoma, a type of intraocular melanoma. Class 1 uveal melanoma has a better prognosis than class 2 uveal melanoma. […] People with intraocular melanoma whose tumours have Ki-67 have a risk of the cancer spreading to other parts of the body. […] Younger people have a better prognosis than older people.

• #1 Prognosis and survival for eye cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/eye/prognosis-and-survival

  Cancer that has spread outside of the eye has a less favourable prognosis than cancer that hasnt spread outside of the eye. […] Spindle cell intraocular melanoma has a better prognosis than epithelioid cell intraocular melanoma or mixed cell intraocular melanoma (this is a mix of both types of cells). […] Eye cancer that has a low mitotic count has a better prognosis than an eye cancer with a higher mitotic count. […] Generally, a smaller eye tumour has a better prognosis than a larger tumour. […] People with small to medium-sized intraocular melanoma are also more likely to be able to see with the affected eye after treatment compared to people with larger tumours. […] Some changes to chromosomes are linked to a higher risk of the cancer spreading and a poorer prognosis. […] People who have an extra part of chromosome 6, called a 6p gain, tend to have a better prognosis.

• #1 Uveal Melanoma: Comprehensive Review of Its Pathophysiology, Diagnosis, Treatment, and Future Perspectives

  https://www.mdpi.com/2227-9059/12/8/1758

  Survival rate for UM depends on a variety of factors, ranging from clinical, molecular, histopathological, and genetic characteristics. Tumor location influences prognosis, with tumors located within 1 mm of the optic nerve head (juxtapapillary) or having any tumor portion located in the ciliary body being associated with a low survival rate. Tumor location is also known to influence time of disease detection; iris melanomas are typically diagnosed one to two decades earlier, which may contribute to lower metastasis rates and greater prognosis. Another important feature to consider during prognostication is somatic mutations. Risk of UM metastasis has been shown to be linked to few somatic mutations in the presence of chromosome 3 monosomy or partial monosomy. Increased risk of metastasis was shown in tumors harboring 6p loss, 6q loss, 8p loss, and 8q gain, whereas the risk of metastasis was decreased in tumors with 6p gains.

• #1 Assessment of the effect of iris colour and having children on 5-year risk of death after diagnosis of uveal melanoma: a follow-up study | BMC Ophthalmology | Full Text

  https://bmcophthalmol.biomedcentral.com/articles/10.1186/1471-2415-14-42

  The 5-year uveal melanoma-specific survival probability was 82.9% (95% CI: 79.1-86.3). […] Main prognostic factors for the death of uveal melanoma were ciliary body involvement (HR: 1.7 (95% CI:1.0-2.8)), largest basal tumour diameter 15 mm HR: 7.0 (95% CI: 3.5-13.9), light iris colour (HR: 2.3 (95% CI: 0.9-5.8), having children (HR: 0.6 (95% CI: 0.2 – 1.7)), and gender (HR: 0.7 (95% CI: 0.4-1.1)). […] Beyond the established prognostic factors, light iris colour also appears to be a prognostic factor for death from uveal melanoma. […] The adjusted HR for women with children was 0.6 (95% CI: 0.2 – 1.7) compared to women without children. […] We found an association between iris colour and uveal melanoma death. Patients with light iris colour had a 2.3-fold increased risk of death from uveal melanoma compared to patients with dark iris colour, independent of other prognostic factors. […] Our results indicate that women with children have a reduced risk of uveal melanoma death.

• #1

  https://journals.lww.com/ijo/fulltext/2021/07000/ten_year_outcomes_of_uveal_melanoma_based_on_the.43.aspx

  To understand the prognostic value of The Cancer Genome Atlas (TCGA) for uveal melanoma metastasis, using a simplified 4-category classification, based on tumor DNA. […] A simplified 4-category classification of uveal melanoma using TCGA, based on tumor DNA, is highly predictive of risk for metastatic disease. […] By comparison, increasing category (A vs. B vs. C vs. D) was associated with the increased rate of any melanoma metastasis (3% vs. 9% vs. 20% vs. 46%, P 0.001), shorter mean time to any metastasis (37.4 vs. 38.7 vs. 27.7 vs. 21.5, P = 0.009), and specifically the increased rate of liver metastasis (2% vs. 9% vs. 20% vs. 46%, P 0.001), lung metastasis (1% vs. 1% vs. 4% vs. 10%, P 0.001), metastasis to other systemic locations (bone, brain, breast, intestine, distant lymph nodes, mesentery, muscle, skin) (1% vs. 4% vs. 5% vs. 14%, P 0.001), and melanoma-related death (1% vs. 0% vs. 2% vs. 7%, P = 0.003).

• #1 Uveal melanoma: Estimating prognosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4399142/

  Uveal melanoma has a high tendency to metastasize resulting in high mortality. The common sites of metastasis include liver (89%), lung (29%), and bone (17%). Approximately, 50% of patients with uveal melanoma succumb to metastasis within 10 years of diagnosis, irrespective of the type of treatment. Median survival after metastasis is 6 to 12 months, though long-term survival has been reported. Though, the overall survival rate of patients with metastatic uveal melanoma is poor, median survival of patients receiving treatment for metastasis is better than those receiving no treatment. […] Various clinical, histopathological, and cytogenetic features of uveal melanoma can identify those patients who are at high risk of developing metastasis and probably benefit from appropriate prophylactic/therapeutic adjuvant and adjunctive treatments.

• #1 Survival statistics for eye cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/eye/prognosis-and-survival/survival-statistics

  Survival statistics for eye cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival. […] In Canada, the 5-year net survival for eye cancer is 74%. This means that about 74% of people diagnosed with eye cancer will survive for at least 5 years. […] Survival varies with the stage of intraocular melanoma. Intraocular melanoma tends to grow slowly. Generally, the earlier it is diagnosed and treated, the better the outcome. […] The 10-year survival rate is the percentage of people who are alive at least 10 years after their cancer diagnosis. But people with this type of cancer may live much longer than 10 years. […] For people with metastatic disease, the median survival is 4.517 months. Median survival is the period of time (usually months or years) at which half of the people with cancer are still alive. The other half will live less than this amount of time. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.

• #1 Melanoma in the Eye (Intraocular): Uveal and Conjunctival

  https://www.cancercenter.com/cancer-types/melanoma/types/intraocular-melanoma

  The ASCO outlines five-year survival rates for intraocular melanoma. This statistic means the percentage of individuals surviving five years after their cancer diagnosis. For those whose eye cancers were diagnosed at an early stage, meaning without spread, the five-year survival rate is 85 percent. For eye cancers that have spread into surrounding tissue or organs and/or nearby lymph nodes, the rate is 71 percent. For eye cancers that have spread to distant parts of the body at the time of diagnosis, the rate is 13 percent. […] Survival rates also depend on the type of melanoma. For iris melanoma, which doesn’t typically spread, the five-year survival rate is more than 95 percent. For choroidal melanoma, the five-year survival rates vary by the size. Small choroidal melanoma: 84 percent, Medium choroidal melanoma: 68 percent, Large choroidal melanoma: 47 percent.

• #1 Survival For Eye Cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/eye-cancer/survival

  Survival depends on different factors. So no one can tell you exactly how long you will live. […] Because this cancer is less common, survival is harder to estimate than for other, more common cancers. […] Your outlook depends on the stage of the cancer when it was diagnosed. This means how big it is and whether it has spread. […] The type of cancer can also affect your survival. […] Sometimes doctors can test for changes in the chromosomes of an eye melanoma that give an idea about how the cancer will behave and how likely it is to spread. […] Your general health and fitness also affect survival. The fitter you are, the better you may be able to cope with your cancer and treatment. […] Generally for people with conjunctival melanoma in England: almost all survive their cancer for 1 year or more; around 90 out of 100 (around 90%) survive their cancer for 5 years or more. […] Generally for people with uveal melanoma in England: around 95 out of 100 (around 95%) survive their cancer for 1 year or more; almost 80 out of 100 (almost 80%) survive their cancer for 5 years or more.

• #1 Uveal melanoma: Estimating prognosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4399142/

  The overall survival could be related to the characteristics of the intraocular portion of the tumor rather than the EOE, except when the size of the EOE is large (5 mm). In a study of 610 patients with uveal melanoma, the 5-year mortality rate for patients with a microscopic extension and small EOE (1-4 mm) were 37% and 24%, respectively. These numbers were markedly higher for patients with large EOE with 5-year mortality rate of 78%. […] The long-term prognosis of uveal melanoma is poor with death occurring in more than 50% cases. The prognosis of uveal melanoma can be estimated by clinical, histopathological, cytogenetic, and transcriptomic markers. Improved prognostication for uveal melanoma allows identification of patients at high risk for metastasis, thereby facilitating targeted screening, and probable adjunctive/adjuvant systemic treatment. Currently, the most effective measure to minimize poor prognosis is early detection of melanoma at a time when the tumor is small and at least risk for metastatic disease.

• #1

  https://link.springer.com/article/10.1007/s11764-021-01036-4

  Prognostication in cancer is growing in importance as increasingly accurate tools are developed. Prognostic accuracy intensifies ethical concerns that a poor prognosis could be psychologically harmful to survivors. Uveal melanoma (UM) prognostication allows survivors to be reliably told that life expectancy is either normal (good prognosis) or severely curtailed because of metastatic disease (poor prognosis). Treatment cannot change life expectancy. To identify whether prognosis is associated with psychological harm, we compared harm in UM survivors with good and poor prognoses and those who declined testing and compared these outcomes to general population norms. […] Compared to other groups, survivors with poor prognoses showed initially elevated anxiety and depression and consistently elevated worry about local or distant recurrence over 5 years. Good prognoses were not associated with outcomes. Generally, no prognostic groups reported anxiety, depression and WREC or QoL scores that exceeded general population norms.

• #1

  https://link.springer.com/article/10.1007/s11764-021-01036-4

  Using a large sample, we found that harm accruing from a poor prognosis was statistically significant over 5 years, but did not exceed general non-cancer population norms. […] Survivors desire prognostic information. At a population level, we do not believe that our findings show sufficiently strong links between prognostication outcome and psychological harm to deny patients the option of knowing their prognosis. Nonetheless, it is important that patients are informed of potential adverse psychological consequences of a poor prognosis. […] Poor prognosis (M3 group membership) was associated with higher intercept scores for anxiety, depression and WREC, indicating that poor prognoses may cause initially higher scores on these variables. Anxiety and depression showed negative associations with slope scores, suggesting that initial gaps closed. Thus, poor prognosis was associated with initially higher anxiety and depression that reduced over time and associated with enduring elevations on WREC. Poor prognosis did not predict QoL. Good prognosis (D3 group membership) did not predict any outcome compared to not tested survivors. Nonetheless, survivors with a poor prognosis did not show markedly higher scores than population norms for any outcome. Thus, whilst survivors with a poor prognosis did experience greater anxiety, depression and WREC, outcomes were generally not worse than those experienced by the general population.

• #1 Uveal Melanoma: Comprehensive Review of Its Pathophysiology, Diagnosis, Treatment, and Future Perspectives

  https://www.mdpi.com/2227-9059/12/8/1758

  Uveal melanoma (UM) is the most common primary intraocular malignancy in adults, with an incidence of nearly 5 cases per million individuals in the United States. Mortality from metastatic UM was shown to be of 30% at 5 years in a Swedish cohort. Furthermore, 40% fatality rates in UM were shown in patients 10 to 15 years following primary diagnosis. Colorectal and liver metastasis are the leading causes of death in UM patients. Furthermore, UM comes with a psychosocial burden on affected patients, with a great impact on their quality of life. Although numerous advances in the treatment of UM have been made over the past few years, such as the development of tebentafusp—an immune system regulator—the prognosis of UM remains poor. Current beliefs are in favor of the presence of micrometastatic disease at the time of diagnosis, as a result of the hematogenous spread of cancer cells. Delays in diagnosis and treatment are suggested to be major contributors to metastatic disease as well. Therefore, there is an urgent need to identify novel therapeutic targets in combination with highly sensitive and specific diagnostic tools.

• #1 Uveal Melanoma: Comprehensive Review of Its Pathophysiology, Diagnosis, Treatment, and Future Perspectives

  https://www.mdpi.com/2227-9059/12/8/1758

  The presence of circulating neoplastic-immune hybrid cells (CHCs) in the blood—corresponding to dual nature hybrid cells in the primary tumor—and tumor-derived extracellular vesicles (TEVs) in the pathogenesis of metastatic UM. CHCs could be used as a novel tool to stratify prognostic risk, as they were shown to be present in the peripheral blood of all patients with stage 1 to stage 3 UMs. Their relatively high prevalence, cost-effective quantification, and less invasive sampling through liquid biopsies provide an exciting venue for research.

• #2 Assessment of the effect of iris colour and having children on 5-year risk of death after diagnosis of uveal melanoma: a follow-up study | BMC Ophthalmology | Full Text

  https://bmcophthalmol.biomedcentral.com/articles/10.1186/1471-2415-14-42

  The 5-year uveal melanoma-specific survival probability was 82.9% (95% CI: 79.1-86.3). […] Main prognostic factors for the death of uveal melanoma were ciliary body involvement (HR: 1.7 (95% CI:1.0-2.8)), largest basal tumour diameter 15 mm HR: 7.0 (95% CI: 3.5-13.9), light iris colour (HR: 2.3 (95% CI: 0.9-5.8), having children (HR: 0.6 (95% CI: 0.2 – 1.7)), and gender (HR: 0.7 (95% CI: 0.4-1.1)). […] Beyond the established prognostic factors, light iris colour also appears to be a prognostic factor for death from uveal melanoma. […] The adjusted HR for women with children was 0.6 (95% CI: 0.2 – 1.7) compared to women without children. […] We found an association between iris colour and uveal melanoma death. Patients with light iris colour had a 2.3-fold increased risk of death from uveal melanoma compared to patients with dark iris colour, independent of other prognostic factors. […] Our results indicate that women with children have a reduced risk of uveal melanoma death.

• #2 Uveal melanoma: Estimating prognosis

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4399142/

  The overall survival could be related to the characteristics of the intraocular portion of the tumor rather than the EOE, except when the size of the EOE is large (5 mm). In a study of 610 patients with uveal melanoma, the 5-year mortality rate for patients with a microscopic extension and small EOE (1-4 mm) were 37% and 24%, respectively. These numbers were markedly higher for patients with large EOE with 5-year mortality rate of 78%. […] The long-term prognosis of uveal melanoma is poor with death occurring in more than 50% cases. The prognosis of uveal melanoma can be estimated by clinical, histopathological, cytogenetic, and transcriptomic markers. Improved prognostication for uveal melanoma allows identification of patients at high risk for metastasis, thereby facilitating targeted screening, and probable adjunctive/adjuvant systemic treatment. Currently, the most effective measure to minimize poor prognosis is early detection of melanoma at a time when the tumor is small and at least risk for metastatic disease.

• #2 Uveal Melanoma: Comprehensive Review of Its Pathophysiology, Diagnosis, Treatment, and Future Perspectives

  https://www.mdpi.com/2227-9059/12/8/1758

  Survival rate for UM depends on a variety of factors, ranging from clinical, molecular, histopathological, and genetic characteristics. Tumor location influences prognosis, with tumors located within 1 mm of the optic nerve head (juxtapapillary) or having any tumor portion located in the ciliary body being associated with a low survival rate. Tumor location is also known to influence time of disease detection; iris melanomas are typically diagnosed one to two decades earlier, which may contribute to lower metastasis rates and greater prognosis. Another important feature to consider during prognostication is somatic mutations. Risk of UM metastasis has been shown to be linked to few somatic mutations in the presence of chromosome 3 monosomy or partial monosomy. Increased risk of metastasis was shown in tumors harboring 6p loss, 6q loss, 8p loss, and 8q gain, whereas the risk of metastasis was decreased in tumors with 6p gains.

• #2 Prognosis and survival for eye cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/eye/prognosis-and-survival

  Cancer that has spread outside of the eye has a less favourable prognosis than cancer that hasnt spread outside of the eye. […] Spindle cell intraocular melanoma has a better prognosis than epithelioid cell intraocular melanoma or mixed cell intraocular melanoma (this is a mix of both types of cells). […] Eye cancer that has a low mitotic count has a better prognosis than an eye cancer with a higher mitotic count. […] Generally, a smaller eye tumour has a better prognosis than a larger tumour. […] People with small to medium-sized intraocular melanoma are also more likely to be able to see with the affected eye after treatment compared to people with larger tumours. […] Some changes to chromosomes are linked to a higher risk of the cancer spreading and a poorer prognosis. […] People who have an extra part of chromosome 6, called a 6p gain, tend to have a better prognosis.

• #2

  https://journals.lww.com/ijo/fulltext/2021/07000/ten_year_outcomes_of_uveal_melanoma_based_on_the.43.aspx

  In conclusion, we have updated our database regarding prognostic classification of uveal melanoma by the 4-category TCGA and now provide 10-year outcomes for any metastasis and specifically for metastasis to the liver, lung, and other sites. We have shown that increasing TCGA grouping leads to a significantly (P 0.001) increased risk for metastatic events and death over time. This classification system is practical and highly predictive of uveal melanoma metastatic risk.

• #2 Survival statistics for eye cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/eye/prognosis-and-survival/survival-statistics

  Survival statistics for eye cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival. […] In Canada, the 5-year net survival for eye cancer is 74%. This means that about 74% of people diagnosed with eye cancer will survive for at least 5 years. […] Survival varies with the stage of intraocular melanoma. Intraocular melanoma tends to grow slowly. Generally, the earlier it is diagnosed and treated, the better the outcome. […] The 10-year survival rate is the percentage of people who are alive at least 10 years after their cancer diagnosis. But people with this type of cancer may live much longer than 10 years. […] For people with metastatic disease, the median survival is 4.517 months. Median survival is the period of time (usually months or years) at which half of the people with cancer are still alive. The other half will live less than this amount of time. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.

• #2 Melanoma in the Eye (Intraocular): Uveal and Conjunctival

  https://www.cancercenter.com/cancer-types/melanoma/types/intraocular-melanoma

  The ASCO outlines five-year survival rates for intraocular melanoma. This statistic means the percentage of individuals surviving five years after their cancer diagnosis. For those whose eye cancers were diagnosed at an early stage, meaning without spread, the five-year survival rate is 85 percent. For eye cancers that have spread into surrounding tissue or organs and/or nearby lymph nodes, the rate is 71 percent. For eye cancers that have spread to distant parts of the body at the time of diagnosis, the rate is 13 percent. […] Survival rates also depend on the type of melanoma. For iris melanoma, which doesn’t typically spread, the five-year survival rate is more than 95 percent. For choroidal melanoma, the five-year survival rates vary by the size. Small choroidal melanoma: 84 percent, Medium choroidal melanoma: 68 percent, Large choroidal melanoma: 47 percent.

• #3 Survival statistics for eye cancer | Canadian Cancer Society

  https://cancer.ca/en/cancer-information/cancer-types/eye/prognosis-and-survival/survival-statistics

  Survival statistics for eye cancer are very general estimates and must be interpreted very carefully. Because these statistics are based on the experience of groups of people, they cannot be used to predict a particular persons chances of survival. […] In Canada, the 5-year net survival for eye cancer is 74%. This means that about 74% of people diagnosed with eye cancer will survive for at least 5 years. […] Survival varies with the stage of intraocular melanoma. Intraocular melanoma tends to grow slowly. Generally, the earlier it is diagnosed and treated, the better the outcome. […] The 10-year survival rate is the percentage of people who are alive at least 10 years after their cancer diagnosis. But people with this type of cancer may live much longer than 10 years. […] For people with metastatic disease, the median survival is 4.517 months. Median survival is the period of time (usually months or years) at which half of the people with cancer are still alive. The other half will live less than this amount of time. […] Only a doctor familiar with these factors can put all of this information together with survival statistics to arrive at a prognosis.

Zobacz więcej