Endoresection for Large Choroidal Melanoma After Proton Beam: Preliminary Results

Abstract

Purpose: : to evaluate the benefits of endoresection for large choroidal melanoma after proton beam irradiation in reducing the rate of secondary enucleation.

Methods: : Monocentric prospective study. Were included patients with large choroidal melanoma of at least 6mm in thickness. Surgery was done 3 months or more after proton beam irradiation. Were excluded patients in witch a primary enucleation was recommended, tumors that invade the optic nerve head or ciliary body, contra indication for general anaesthesia. Endoresection was performed after pars plana vitrectomy followed by a silicon oil tamponade.

Results: : since the 1st of January 08, 48 patients mean age 55 year-old (17-81 y-o) were included. Median time between irradiation and surgery was 4.4 months (2-12 m). Mean tumor diameter was 13.9 mm (2.7-19 mm), mean tumor thickness was 8.6 mm (6.3-12.2mm). Before surgery 91.8% of patients presented a retinal detachment. Neovascular glaucome was present for 2 patients. Tumor was removed and retina was reattached in all the patients except for 2 of them. Post operative complications included hyphema in 10.20%, retinal detachment relapse in 6.1%. No neovascular glaucoma, no local recurrence of the tumor, were observed after a mean follow-up of 11 months (2-21 months).

Conclusions: : These preliminary results showed that endoresection is a safe procedure after proton beam irradiation and can improve eye retention for the biggest tumors.

Clinical Trial: : curie 00012

Keywords: tumors • melanoma • radiation therapy