Sestre Milosrdnice University hospital and Institute of Clinical Medical Research
Abstract
The aim of the study was to determine clinical and histopathologic prognostic factors for tumor related survival of patients with uveal melanoma. Clinical and histopathologic records of 20 patients with histologically verified uveal melanomas were retrospectively analyzed. Patients were operated on at University Department of Ophthalmology, Split University Hospital in Split, January 1, 1991 and December 31, 2000. Histopathologic confirmation was obtained from the Hospital Department of Pathology, Forensic Medicine and Cytology, Split University Hospital. Standard histological staining with hemalaun and immunohistochemical staining with primary antibody against melanoma antigen and S-100 protein were performed. Data on the cause of death were collected from death certificates obtained from Hospital Department of Pathology, Forensic Medicine and Cytology and from Split Population Registry, Split-Dalmatia County government. The overall annual incidence of uveal melanoma in Split-Dalmatian County was 0.44 per 100,000. Out of 20 intraocular melanomas, 4 (20%) were located at the ciliary body, 13 (65%) at the choroid, and 3 (15%) at the ciliary body and at the choroid. There was no statistically significant survival difference between groups with different tumor localization (c²=2.747; df=3; p=0.253). The largest tumor diameter was 35 mm and the smallest 9 mm (median 12 mm), and there was no statistically significant correlation between tumor diameter and survival (Spearman\u27s correlation 0.21). Histological study revealed pure spindle A type melanoma in one (5%) case, pure spindle B type melanoma and pure epithelioid type melanoma in 4 (20%) cases each, and mixed type melanoma in 11 (55%) cases. There was no statistically significant survival difference between groups of patients with different histopathologic types of melanoma (χ²=5.312; df=4; p=0.150). Study results indicated that none of the study parameters (localization, tumor diameter and histopathology finding) could be considered a valid prognostic factor of uveal melanoma survival.Cilj studije bio je ustanoviti kliničke i patohistološke prognostičke čimbenike preživljenja od melanoma srednje očne ovojnice kod bolesnika s tom bolešću. Provedena je retrospektivna analiza kliničkih i patohistoloških podataka 20 bolesnika s histološki dokazanim melanomom srednje očne ovojnice. Bolesnici su operirani u Klinici za očne bolesti KB Split u razdoblju od 1. siječnja 1991. do 31. prosinca 2000. godine. Melanomi su patohistološki verificirani u Zavodu za patologiju, sudsku medicinu i citologiju KB Split. Primijenjeno je standardno HE (hemalaun-eozin) bojenje i imunohistokemijsko bojenje na melanoma antigen i S-100 protein. Uzrok smrti utvrđen je uvidom u mrtvozorničke prijave o uzroku smrti u Zavodu za patologiju, sudsku medicinu i citologiju KB Split i u Matičnom uredu Split, Uredu državne uprave Splitsko-dalmatinske županije. Godišnja incidencija melanoma srednje očne ovojnice u Splitsko-dalmatinskoj županiji bila je 0,44 na 100.000 stanovnika. Od 20 intraokularnih melanoma, 4 (20%) su imala polazište iz zrakastog tijela, 13 (65%) iz žilnice, a 3 (15%) su bila smještena u zrakastom tijelu i žilnici. Nije nađena statistički značajna razlika u preživljenju prema lokalizaciji tumora (χ²=2,747; df=3; p=0,253). Najveći promjer tumora iznosio je 35 mm, najmanji 9 mm (medijan 12 mm). Nije utvrđena statistički značajna korelacija između preživljenja i veličine tumora (Spermanova rang korelacija 0,21). Histološka analiza utvrdila je 1 (5%) melanom vretenastog tipa A, 4 (20%) vretenastog tipa B, 4 (20%) epiteloidnog tipa i 11 (55%) miješanog tipa. Nije dokazana statistički značajna razlika u preživljenju ovisno o patohistološkom tipu tumora (χ²=5,312; df=4; p=0,15). Na temelju dobivenih rezultata može se zaključiti kako niti jedan od ispitivanih parametara (lokalizacija, veličina i patohistološki tip tumora) nije valjan prognostički čimbenik preživljenja kod melanoma srednje očne ovojnice
