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Y. Shildkrot, W. E. Gordon, M. E. Smith, B. G. Haik, M. W. Wilson; Long Term Survival in Patients With Large Ciliary Body and Choroidal Melanomas Treated With Iodine-125 Plaque Brachytherapy. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5704.
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To determine all-cause mortality at five and ten years in patients with large ciliary body and choroidal melanomas treated with Iodine-125 episcleral plaque brachytherapy.
A retrospective chart review was conducted to identify patients meeting the collaborative ocular melanoma study (COMS) criteria for large melanomas, including apical height greater than 10 mm and/or maximal basal diameter in excess of 16 mm. Medical records and social security death registries were queried as to the vital status of the patients up to November 2008. Statistical analysis was performed using Kaplan-Meier product limit method and ANOVA test.
109 of 112 patients, median age 62 years (range, 13 to 86), treated between December 1986 and December 2001 had follow-up survival data. Overall survival was 39.5% over median follow-up of 120 months (range, 7 - 21 years). Unadjusted cumulative survival rates were 58.9 ± 0.05% at 5 years and 46.1 ± 0.05 % at 10 years as calculated by product-limit method (see Figure). Median time to death was 3.5 years (range, 0.4 - 13.6). Patients who died were older at the time of their plaque placement (66.1 ± 1.7 years vs. 51.3 ± 2.1 years, p < 0.0001) and had larger maximum basal diameter (18.3 ± 0.37 mm vs 17.1 ± 0.33 mm, p = 0.0098), but no difference was observed in apical tumor height (9.57 ± 0.33 mm vs 9.50 ± 0.41mm, p > 0.9). The presence of a retinal detachment at the time of diagnosis was associated with higher likelihood of death (77.5% vs. 43.9%, p = 0.0016), independent of the age at which the plaque was placed.
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