Study finds no definitive clinical markers to differentiate class 1, class 2 uveal melanomas

Issue: September 10, 2012

Class 2 uveal melanomas demonstrated a higher tumor-related mortality rate and were linked to thicker tumors, older patient age and epithelioid pathology, but no definitive clinical markers could be found to differentiate class 1 and class 2 tumors, according to a study.

“Tumor thickness and patient age at diagnosis are statistically different between class 1 and class 2 tumors, but there is a large variability in most clinical parameters in both classes that keeps these characteristics from definitively indicating a specific class,” the study authors said.

The masked, retrospective, single-center case series included 197 patients with uveal melanoma who were analyzed for pathology, clinical characteristics and response to proton beam radiation therapy. Mean age was 64 years for patients with class 2 tumors and 57 years for patients with class 1 tumors.

Class 1 tumors were present in 126 patients, while class 2 tumors were present in 71 patients. Patients with class 2 tumors had thicker initial mean ultrasound measurements (7.4 mm vs. 5.9 mm, P = .0007) and were found to be more likely to have epithelioid or mixed cells on cytopathology (66% vs. 38%, P = .0004).

Despite significant differences between class 1 and class 2 mean ultrasound thicknesses before and after treatment, there was no significant difference in the mean change in thickness 24 months after radiation therapy or in the overall rate of thickness change.

“The findings in our study provide further evidence of the predictive accuracy of gene expression profiling for uveal melanomas,” the study authors said. “Not only can genetic classification of the tumors help determine the possibility for metastasis, but it allows us to consider adjunctive treatment in patients at high risk but without evidence of widespread disease.”

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Source:

Am J Ophthalmol. 2012;154(2):227-232.