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Swathi Kaliki, Carol L. Shields, Minoru Furuta, Jerry A. Shields; Diffuse versus Non-diffuse Choroidal Melanoma: Comparative study. Invest. Ophthalmol. Vis. Sci. 2012;53(14):3388.
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To determine and compare the prognosis of small choroidal melanoma (< 3 millimeters thickness) comparing diffuse versus (vs) non-diffuse configuration.
Diffuse choroidal melanoma (flat configuration) was compared with non-diffuse small choroidal melanoma (dome-shaped configuration) retrospectively.
In the diffuse melanoma group (n=297), 29 (10%) patients developed metastasis and 21 (7%) melanoma-related death over mean follow-up period of 76 months. In the non-diffuse melanoma group (n=1454), 89 (6%) patients developed metastasis and 34 (2%) melanoma-related death occurred over mean follow-up period of 75 months. Using Kaplan-Meier survival estimates, the probability of developing metastasis in patients with diffuse vs non-diffuse choroidal melanoma was 5% vs 2% at 3 years, 8% vs 4% at 5 years, 17% vs 10% at 10 years (p=0.0344). The probability of melanoma-related death was 3% vs <1% at 3 years, 6% vs 2% at 5 years, 11% vs 4% at 10 years (p<0.0001). By multivariate analysis, factors predictive of metastasis included larger tumor basal dimension (p=0.0027) and plateau tumor configuration (p=0.0257) for diffuse melanoma vs extraocular extension (p=0.0207) for non-diffuse choroidal melanoma. Factors predictive of death included extraocular extension (p=0.0016) and plateau tumor configuration (p=0.0002) for diffuse melanoma vs amelanotic melanoma (p=0.0157) for non-diffuse choroidal melanoma.
Patients with small choroidal melanoma show statistically higher probability of metastasis and death if tumor configuration is diffuse compared to non-diffuse.
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