Demographic Characterization of Uveal Melanoma Population in Portugal
Autor(a) principal: | |
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Data de Publicação: | 2023 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | https://doi.org/10.48560/rspo.28274 |
Resumo: | INTRODUCTION: Uveal melanoma (UM) is the most common intraocular tumor and although rare, remains a clinical challenge for ocular oncologists. Therapeutic options have evolved throughout the years, focusing in eye-conserving modalities. However, long-term survival remains unchanged. Advances in early diagnosis and treatment represent a step forward in improving patients’ outcomes and survival. The purpose of this study is to characterize demographically and clinically the Portuguese population with uveal melanoma evaluated at the National Reference Centre (NRC). METHODS: Prospective, observational study of patients consecutively diagnosed with UM at the Portuguese NRC, between January 2016 and December 2021. Data was collected regarding tumor characteristics, staging (American Joint Committee on Cancer – AJCC), demographic assessment, treatment modality, local control, patient survival and distant metastasis. RESULTS: A total of 215 patients (53% female) were included. The mean age at diagnosis was 61.5± 14.0 years, with symptoms at presentation reported by 75.6%. Choroidal location was the most frequent (83.3%), followed by ciliary body (10.2%), iridociliary (3.3%) and iris (1.4%). The AJCC stage IIA and IIB were the most common at presentation (33.0% and 32.6%, respectively); stage IIIC was the less observed (n=3). Mean baseline basal diameter and thickness were, respectively, 11.7± 3.7 and 6.9±3.4 mm. Primary treatment comprised brachytherapy (n=152, 70.7%), enucleation (n=50, 23.3%), proton beam radiation (n=8, 3.7%) and tumor resection (n=5, 2.3%; only for iris tumors). Mean disease-specific survival (DSS) was 45.8 months (95%CI: 44.5-47.1 months), with a cumulative survival of 89.4 months (95%CI: 83.1-95.7) at 4 years. Mean distant metastases free survival (DMFS) was 53.4 months (95% CI: 50.8-56.0 months), with a cumulative survival of 83.9 months (95% CI: 76.7-91) at 4 years. Higher AJCC stages at presentation, enucleation and increased tumor thickness were associated with lower DSS and DMFS rates. CONCLUSION: This is the first characterization of the Portuguese Population diagnosed with UM in the NRC. Our results highlight the importance of an early diagnosis given that almost 25% of patients were enucleated primarily and were not candidates for globe-sparing treatments. Lower AJCC stages and decreased tumor thickness at the time of diagnosis correlated with better DSS and DMFS, emphasizing the advantages of early treatment. |
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Demographic Characterization of Uveal Melanoma Population in PortugalCaracterização Demográfica da População Diagnosticada com Melanoma da Úvea em PortugalArtigos OriginaisINTRODUCTION: Uveal melanoma (UM) is the most common intraocular tumor and although rare, remains a clinical challenge for ocular oncologists. Therapeutic options have evolved throughout the years, focusing in eye-conserving modalities. However, long-term survival remains unchanged. Advances in early diagnosis and treatment represent a step forward in improving patients’ outcomes and survival. The purpose of this study is to characterize demographically and clinically the Portuguese population with uveal melanoma evaluated at the National Reference Centre (NRC). METHODS: Prospective, observational study of patients consecutively diagnosed with UM at the Portuguese NRC, between January 2016 and December 2021. Data was collected regarding tumor characteristics, staging (American Joint Committee on Cancer – AJCC), demographic assessment, treatment modality, local control, patient survival and distant metastasis. RESULTS: A total of 215 patients (53% female) were included. The mean age at diagnosis was 61.5± 14.0 years, with symptoms at presentation reported by 75.6%. Choroidal location was the most frequent (83.3%), followed by ciliary body (10.2%), iridociliary (3.3%) and iris (1.4%). The AJCC stage IIA and IIB were the most common at presentation (33.0% and 32.6%, respectively); stage IIIC was the less observed (n=3). Mean baseline basal diameter and thickness were, respectively, 11.7± 3.7 and 6.9±3.4 mm. Primary treatment comprised brachytherapy (n=152, 70.7%), enucleation (n=50, 23.3%), proton beam radiation (n=8, 3.7%) and tumor resection (n=5, 2.3%; only for iris tumors). Mean disease-specific survival (DSS) was 45.8 months (95%CI: 44.5-47.1 months), with a cumulative survival of 89.4 months (95%CI: 83.1-95.7) at 4 years. Mean distant metastases free survival (DMFS) was 53.4 months (95% CI: 50.8-56.0 months), with a cumulative survival of 83.9 months (95% CI: 76.7-91) at 4 years. Higher AJCC stages at presentation, enucleation and increased tumor thickness were associated with lower DSS and DMFS rates. CONCLUSION: This is the first characterization of the Portuguese Population diagnosed with UM in the NRC. Our results highlight the importance of an early diagnosis given that almost 25% of patients were enucleated primarily and were not candidates for globe-sparing treatments. Lower AJCC stages and decreased tumor thickness at the time of diagnosis correlated with better DSS and DMFS, emphasizing the advantages of early treatment.INTRODUÇÃO: O melanoma da úvea (UM) é o tumor intraocular mais comum, constituindo um desafio clínico para os oncologistas oculares. Opções terapêuticas têm evoluído ao longo dos anos, centrando-se em modalidades conservadoras. Contudo, o prognóstico a longo prazo mantém-se reservado. No entanto, avanços no diagnóstico e terapêutica precoces podem vir a mudar este paradigma. Este estudo tem como objetivo caracterizar demográfica e clinicamente a população portuguesa com o diagnóstico de UM no Centro de Referência Nacional (NRC). MÉTODOS: Conduziu-se um estudo prospetivo observacional de doentes consecutivamente diagnosticados com UM no NRC, entre janeiro de 2016 e dezembro de 2021. Foram colhidos dados respeitando as características tumorais, estadio (American Joint Committee on Cancer – AJCC), dados demográficos, modalidade de tratamento, controlo local, sobrevida e metástases à distância. RESULTADOS: Foram incluídos 215 doentes (53% do sexo feminino). A idade média de diagnóstico foi 61,5± 14,0 anos, e 75,6% apresentaram-se com sintomas. A localização coroideia foi a mais frequente (83,3%), seguida pelo corpo ciliar (10,2%), iridociliar (3,3%) e íris (1,4%). Os estadios AJCC IIA e IIB foram os mais comuns (33,0% and 32,6%, respetivamente); o estadio IIIC foi o mais raro (n=3). As médias do diâmetro basal e espessura iniciais foram, respetivamente, 11,7± 3,7 e 6,9±3,4 mm. O tratamento primário compreendeu braquiterapia (70,7%), enucleação (23,3%), feixe de protões (3,7%) e resseção tumoral (2,3%). A sobrevida específica de doença (DSS) média foi 45,8 meses (95% CI: 44,5-47,1 meses), com uma sobrevida cumulativa de 89,4% (95%CI: 83,1-95,7) aos 4 anos. A sobrevida livre de metástases à distância (DMFS) média foi 53.4 meses (95% IC: 50,8-56,0 meses), com uma sobrevida cumulativa de 83,9% (95% CI: 76,7-91) aos 4 anos. Estadios AJCC mais avançados, enucleação e maior espessura tumoral correlacionaram-se com piores taxas de DSS e DMFS. CONCLUSÃO: Esta é a primeira caracterização da população portuguesa diagnosticada com UM no NRC. Os nossos resultados realçam a importância do diagnóstico precoce, atendendo que quase 25% dos doentes foram enucleados primariamente, não sendo candidatos a terapêuticas conservadoras. Estadios AJCC mais baixos e menor espessura tumoral à apresentação correlacionaram-se com melhores DSS e DMFS, sublinhando as vantagens do tratamento precoce.Ajnet2023-12-29info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttps://doi.org/10.48560/rspo.28274eng1646-69501646-6950Geada, SaraNeves, EmmanuelTeixeira, TâniaCésar Simões, PauloFonseca, CristinaProença, Ruiinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-01-04T20:30:31Zoai:ojs.revistas.rcaap.pt:article/28274Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T01:30:08.000666Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
Demographic Characterization of Uveal Melanoma Population in Portugal Caracterização Demográfica da População Diagnosticada com Melanoma da Úvea em Portugal |
title |
Demographic Characterization of Uveal Melanoma Population in Portugal |
spellingShingle |
Demographic Characterization of Uveal Melanoma Population in Portugal Geada, Sara Artigos Originais |
title_short |
Demographic Characterization of Uveal Melanoma Population in Portugal |
title_full |
Demographic Characterization of Uveal Melanoma Population in Portugal |
title_fullStr |
Demographic Characterization of Uveal Melanoma Population in Portugal |
title_full_unstemmed |
Demographic Characterization of Uveal Melanoma Population in Portugal |
title_sort |
Demographic Characterization of Uveal Melanoma Population in Portugal |
author |
Geada, Sara |
author_facet |
Geada, Sara Neves, Emmanuel Teixeira, Tânia César Simões, Paulo Fonseca, Cristina Proença, Rui |
author_role |
author |
author2 |
Neves, Emmanuel Teixeira, Tânia César Simões, Paulo Fonseca, Cristina Proença, Rui |
author2_role |
author author author author author |
dc.contributor.author.fl_str_mv |
Geada, Sara Neves, Emmanuel Teixeira, Tânia César Simões, Paulo Fonseca, Cristina Proença, Rui |
dc.subject.por.fl_str_mv |
Artigos Originais |
topic |
Artigos Originais |
description |
INTRODUCTION: Uveal melanoma (UM) is the most common intraocular tumor and although rare, remains a clinical challenge for ocular oncologists. Therapeutic options have evolved throughout the years, focusing in eye-conserving modalities. However, long-term survival remains unchanged. Advances in early diagnosis and treatment represent a step forward in improving patients’ outcomes and survival. The purpose of this study is to characterize demographically and clinically the Portuguese population with uveal melanoma evaluated at the National Reference Centre (NRC). METHODS: Prospective, observational study of patients consecutively diagnosed with UM at the Portuguese NRC, between January 2016 and December 2021. Data was collected regarding tumor characteristics, staging (American Joint Committee on Cancer – AJCC), demographic assessment, treatment modality, local control, patient survival and distant metastasis. RESULTS: A total of 215 patients (53% female) were included. The mean age at diagnosis was 61.5± 14.0 years, with symptoms at presentation reported by 75.6%. Choroidal location was the most frequent (83.3%), followed by ciliary body (10.2%), iridociliary (3.3%) and iris (1.4%). The AJCC stage IIA and IIB were the most common at presentation (33.0% and 32.6%, respectively); stage IIIC was the less observed (n=3). Mean baseline basal diameter and thickness were, respectively, 11.7± 3.7 and 6.9±3.4 mm. Primary treatment comprised brachytherapy (n=152, 70.7%), enucleation (n=50, 23.3%), proton beam radiation (n=8, 3.7%) and tumor resection (n=5, 2.3%; only for iris tumors). Mean disease-specific survival (DSS) was 45.8 months (95%CI: 44.5-47.1 months), with a cumulative survival of 89.4 months (95%CI: 83.1-95.7) at 4 years. Mean distant metastases free survival (DMFS) was 53.4 months (95% CI: 50.8-56.0 months), with a cumulative survival of 83.9 months (95% CI: 76.7-91) at 4 years. Higher AJCC stages at presentation, enucleation and increased tumor thickness were associated with lower DSS and DMFS rates. CONCLUSION: This is the first characterization of the Portuguese Population diagnosed with UM in the NRC. Our results highlight the importance of an early diagnosis given that almost 25% of patients were enucleated primarily and were not candidates for globe-sparing treatments. Lower AJCC stages and decreased tumor thickness at the time of diagnosis correlated with better DSS and DMFS, emphasizing the advantages of early treatment. |
publishDate |
2023 |
dc.date.none.fl_str_mv |
2023-12-29 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://doi.org/10.48560/rspo.28274 |
url |
https://doi.org/10.48560/rspo.28274 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
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1646-6950 1646-6950 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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Ajnet |
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Ajnet |
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reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
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1799136783486681088 |