Abstract
Purpose: :
Cytogenetic profile, mainly monosomy 3 status, is considered the most important prognostic factor in posterior uveal melanoma. The aim of this study was to evaluate long-term safety and adequacy of in-vivo fine needle aspiration biopsy (FNAB) for cytogenetic testing, used in a routine clinical setting.
Methods: :
One hundred thirty-five consecutive cases of posterior uveal melanoma were included in this prospective study. In-vivo 25G FNAB via trans-scleral approach, through the tumor base, was used at the time of the radioactive plaque application (I-125). A double-sampling was performed and separately collected. Fluorescence in Situ Hybridization (FISH) analysis was conducted using standard procedure. All patients underwent a 1-, 3-, 6-month follow-up examination, and every 6 months thereafter. Follow-up was longer than 24 months. Cytogenetic assessment was correlated with metastatic disease.
Results: :
Follow-up was 47 ±15 months (range, 24-88 months). FNAB yielded adequate material for FISH analysis in 111 of 135 cases (82.2%). Monosomy 3 was found in fifty-three cases (47,7%) and disomy 3 in fifty-eight cases (52,3%). Chromosome 6 co-detection was performed in 41 patients. Monosomy 3 and gain 6p resulted mutually exclusive in 37 cases (90.2%). No clinical relevant monosomy 3 heterogeneity was documented. No short and long-term complications or extrascleral extensions were documented during follow up. Twenty-two patients (41,5%) with monosomy 3 and three patients (5.2%) with disomy 3 tumors developed metastatic disease during follow-up. Compared with disomy 3, liver metastases were statistically more likely to occur in monosomy 3 tumors (P<0.001). Among the disomy 3 metastatic cases, no gain of 6p was detected.
Conclusions: :
The use of in-vivo 25G transcleral FNAB appears a safe diagnostic procedure on a long-term basis. It yields relevant prognostic information in patients affected by posterior uveal melanoma.
Keywords: oncology • uvea • tumors