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Allan Topham - One of the best experts on this subject based on the ideXlab platform.

  • survival rates with uveal Melanoma in the united states 1973 1997
    Ophthalmology, 2003
    Co-Authors: Arun D Singh, Allan Topham
    Abstract:

    Abstract Purpose To determine variations in 5-year relative survival rates with primary uveal Melanoma in the United States over a 25-year period from 1973 to 1997. Design Systematic review of existing databases. Participants Two thousand four hundred ninety-three patients with primary uveal Melanoma, International Classification of Oncology [ICDO-2] codes C69.3 [Choroid Melanoma] and C69.4 [ciliary body and iris]) derived from Surveillance, Epidemiology, and End Results (SEER) program database in the United States from 1973 to 1997. Methods The patients were stratified according to the treatment (surgery or radiotherapy). The relative 5-year survival was calculated for 2054 patients diagnosed between 1973 and 1993 by the life table method using US life expectancy tables. Main outcome measures The relative 5-year survival rate. Results Surgical treatment was performed in 1476 (72%) cases, and radiotherapy was given in 300 (15%) cases. The proportion of cases treated by radiotherapy increased progressively from 2% to 28% in 20 years. Relative 5-year survival rates ranged from 77% to 84% without a statistically significant variation. Conclusions Advances made in the local methods of treatment of primary uveal Melanoma have not led to an improvement in survival. Systemic approaches to management of uveal Melanoma are warranted.

  • incidence of uveal Melanoma in the united states 1973 1997
    Ophthalmology, 2003
    Co-Authors: Arun D Singh, Allan Topham
    Abstract:

    Abstract Purpose To determine the incidence of primary uveal Melanoma in the United States over a 25-year period from 1973 to 1997. Design Systematic review of existing databases. Participants Two thousand four hundred ninety-three patients with primary uveal Melanoma (International Classification of Oncology [ICDO-2] codes C69.3 [Choroid Melanoma] and C69.4 [ciliary body and iris]) derived from the Surveillance, Epidemiology, and End Results (SEER) program database in the United States from 1973 to 1997. Methods The significance of trend in age-adjusted incidence rate was determined using chi-square test, and 95% confidence intervals were calculated. Main outcome measures The age-adjusted incidence rate. Results There was a total of 2493 cases of uveal Melanoma, representing 2.9% of all recorded cases of Melanoma. Almost all cases (99.4%) were reported by the hospitals, and histopathologic confirmation was available in 81.3% of cases. The mean age-adjusted incidence of uveal Melanoma in the United States was 4.3 per million (4.1–4.5; 95% confidence interval [CI]). Most cases (97.8%) occurred in the white population. There was significant variation of incidence between genders (males, 4.9 [4.6–5.2] 95% CI interval; females, 3.7 [3.5–3.9] 95% CI interval). There was no significant variation of incidence by the geographic location of the registry and over the entire period of observation (chi-square test). Conclusions The mean age-adjusted incidence of uveal Melanoma (4.3 per million) in the United States is similar to that reported from European countries. The age-adjusted incidence rate of uveal Melanoma has remained stable for the past 25 years.

Arun D Singh - One of the best experts on this subject based on the ideXlab platform.

  • survival rates with uveal Melanoma in the united states 1973 1997
    Ophthalmology, 2003
    Co-Authors: Arun D Singh, Allan Topham
    Abstract:

    Abstract Purpose To determine variations in 5-year relative survival rates with primary uveal Melanoma in the United States over a 25-year period from 1973 to 1997. Design Systematic review of existing databases. Participants Two thousand four hundred ninety-three patients with primary uveal Melanoma, International Classification of Oncology [ICDO-2] codes C69.3 [Choroid Melanoma] and C69.4 [ciliary body and iris]) derived from Surveillance, Epidemiology, and End Results (SEER) program database in the United States from 1973 to 1997. Methods The patients were stratified according to the treatment (surgery or radiotherapy). The relative 5-year survival was calculated for 2054 patients diagnosed between 1973 and 1993 by the life table method using US life expectancy tables. Main outcome measures The relative 5-year survival rate. Results Surgical treatment was performed in 1476 (72%) cases, and radiotherapy was given in 300 (15%) cases. The proportion of cases treated by radiotherapy increased progressively from 2% to 28% in 20 years. Relative 5-year survival rates ranged from 77% to 84% without a statistically significant variation. Conclusions Advances made in the local methods of treatment of primary uveal Melanoma have not led to an improvement in survival. Systemic approaches to management of uveal Melanoma are warranted.

  • incidence of uveal Melanoma in the united states 1973 1997
    Ophthalmology, 2003
    Co-Authors: Arun D Singh, Allan Topham
    Abstract:

    Abstract Purpose To determine the incidence of primary uveal Melanoma in the United States over a 25-year period from 1973 to 1997. Design Systematic review of existing databases. Participants Two thousand four hundred ninety-three patients with primary uveal Melanoma (International Classification of Oncology [ICDO-2] codes C69.3 [Choroid Melanoma] and C69.4 [ciliary body and iris]) derived from the Surveillance, Epidemiology, and End Results (SEER) program database in the United States from 1973 to 1997. Methods The significance of trend in age-adjusted incidence rate was determined using chi-square test, and 95% confidence intervals were calculated. Main outcome measures The age-adjusted incidence rate. Results There was a total of 2493 cases of uveal Melanoma, representing 2.9% of all recorded cases of Melanoma. Almost all cases (99.4%) were reported by the hospitals, and histopathologic confirmation was available in 81.3% of cases. The mean age-adjusted incidence of uveal Melanoma in the United States was 4.3 per million (4.1–4.5; 95% confidence interval [CI]). Most cases (97.8%) occurred in the white population. There was significant variation of incidence between genders (males, 4.9 [4.6–5.2] 95% CI interval; females, 3.7 [3.5–3.9] 95% CI interval). There was no significant variation of incidence by the geographic location of the registry and over the entire period of observation (chi-square test). Conclusions The mean age-adjusted incidence of uveal Melanoma (4.3 per million) in the United States is similar to that reported from European countries. The age-adjusted incidence rate of uveal Melanoma has remained stable for the past 25 years.

Mauricio Veloso Brun - One of the best experts on this subject based on the ideXlab platform.

  • Melanoma de iris corpo ciliar e coroide em um cao da raca poodle
    Acta Scientiae Veterinariae, 2016
    Co-Authors: Luis Felipe Dutra Correa, Rafael Oliveira Chaves, Marilia Teresa De Oliveira, J P S Feranti, Bruna Copat, Dakir Polidoro Neto, Ney Luis Pippi, Mauricio Veloso Brun
    Abstract:

    Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the Choroid coat and others components of the eye. The ocular Melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to orbital exenteration. The objective of this study is to report a case of iris Melanoma involving the ciliary body and the Choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the Choroid coat with perilesional retinal detachment, suggesting iris ciliary body and Choroid Melanoma. Due to the bad prognosis of the affected eye, the patient underwent to orbital exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris Melanoma involving the ciliary body and the Choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed. Discussion: The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic Melanomas. In this report it was observed a nodular staining quite blackened pigmentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the orbital exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and Choroid coat without sclera leakage, so there would be no need for exenteration. The average age of the patients is around nine years old according to published reports, namely older animals as the patient here described. The orbital exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris Melanoma involving the ciliary body and the Choroid coat.

  • Melanoma de iris corpo ciliar e coroide em um cao da raca poodle Melanoma of the iris ciliary body and Choroid in a dog s poodle
    2016
    Co-Authors: Luis Felipe Dutra Correa, Rafael Oliveira Chaves, Marilia Teresa De Oliveira, J P S Feranti, Bruna Copat, Ney Luis Pippi, Dakir Nilton, Polidoro Neto, Mauricio Veloso Brun
    Abstract:

    Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the Choroid coat and others components of the eye. The ocular Melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to orbital exenteration. The objective of this study is to report a case of iris Melanoma involving the ciliary body and the Choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the Choroid coat with perilesional retinal detachment, suggesting iris ciliary body and Choroid Melanoma. Due to the bad prognosis of the affected eye, the patient underwent to orbital exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris Melanoma involving the ciliary body and the Choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed. Discussion: The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic Melanomas. In this report it was observed a nodular staining quite blackened pigmentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the orbital exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and Choroid coat without sclera leakage, so there would be no need for exenteration. The average age of the patients is around nine years old according to published reports, namely older animals as the patient here described. The orbital exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris Melanoma involving the ciliary body

Luis Felipe Dutra Correa - One of the best experts on this subject based on the ideXlab platform.

  • Melanoma de iris corpo ciliar e coroide em um cao da raca poodle
    Acta Scientiae Veterinariae, 2016
    Co-Authors: Luis Felipe Dutra Correa, Rafael Oliveira Chaves, Marilia Teresa De Oliveira, J P S Feranti, Bruna Copat, Dakir Polidoro Neto, Ney Luis Pippi, Mauricio Veloso Brun
    Abstract:

    Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the Choroid coat and others components of the eye. The ocular Melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to orbital exenteration. The objective of this study is to report a case of iris Melanoma involving the ciliary body and the Choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the Choroid coat with perilesional retinal detachment, suggesting iris ciliary body and Choroid Melanoma. Due to the bad prognosis of the affected eye, the patient underwent to orbital exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris Melanoma involving the ciliary body and the Choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed. Discussion: The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic Melanomas. In this report it was observed a nodular staining quite blackened pigmentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the orbital exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and Choroid coat without sclera leakage, so there would be no need for exenteration. The average age of the patients is around nine years old according to published reports, namely older animals as the patient here described. The orbital exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris Melanoma involving the ciliary body and the Choroid coat.

  • Melanoma de iris corpo ciliar e coroide em um cao da raca poodle Melanoma of the iris ciliary body and Choroid in a dog s poodle
    2016
    Co-Authors: Luis Felipe Dutra Correa, Rafael Oliveira Chaves, Marilia Teresa De Oliveira, J P S Feranti, Bruna Copat, Ney Luis Pippi, Dakir Nilton, Polidoro Neto, Mauricio Veloso Brun
    Abstract:

    Background: Melanoma is a primary ocular neoplasm that may affect the iris, ciliary body, the Choroid coat and others components of the eye. The ocular Melanomas have a low metastatic level in dogs when compared to cats. Old animals are more affected than the young ones and there is no breed predilection. A complete eye examination and ocular ultrasound will lead to the diagnosis that will be further confirmed through histopathology. Current treatment of choice is based on the size and the structures involved by the tumor that can range from local resection to orbital exenteration. The objective of this study is to report a case of iris Melanoma involving the ciliary body and the Choroid coat of a Poodle, emphasizing its clinical manifestation, diagnosis and treatment. Case: This study reports a case of an intact male canine Poodle, 15 years old, weighing 5 kg that was referred for care to the Veterinary Teaching Hospital of the Federal University of Santa Maria, Brazil. The owner initially presented a history of a progressive increase dark-colored intraocular volume in the right eye iris of the dog. On the clinical examination, no abnormality was found. On the ophthalmic examination, the right eye possessed misshapen pupil, hyperemia ocular conjunctiva (+) and diffuse corneal opacity (+) with paracentral pigmentation between 7-10 hour. On biomicroscopic examination, using a slit lamp, it was observed an iris distension that was protruding directly into the anterior chamber and a diffuse opacity of the lens. Intraocular pressure was eight mmHg. B-mode ultrasonography revealed a mass involving the iris, ciliary body and the Choroid coat with perilesional retinal detachment, suggesting iris ciliary body and Choroid Melanoma. Due to the bad prognosis of the affected eye, the patient underwent to orbital exenteration procedure. The extracted eyeball was placed in 10% formalin and sent for histopathological examination, which was later reported as showing an iris Melanoma involving the ciliary body and the Choroid coat. The patient was re-examined six months postoperatively and no neoplasm recurrence signs were observed. Discussion: The animal stated in this report showed an increased volume of the right eye and dark pigmentation involving the iris. As highlighted by the actual literature, the size of this kind of neoplasm can vary from small to larger nodules and it can causes relevant anatomical changes. The pigmentation in these cases may vary from dark colors (black or brown) to white, for example, the amelanotic Melanomas. In this report it was observed a nodular staining quite blackened pigmentation. This kind of cancer involves mainly not neutered male dogs, with breed predilection as the German shepherd dogs, Golden Retrievers, Labrador Retrievers and also Poodles, as reported in this case. The treatment suggested by the literature, can range from diode laser therapy to microsurgical resection with enucleation or exenteration, depending on the size of the affected region and structures involved. The treatment of choice in this patient was the orbital exenteration because of the capacity of this tumor to spread throughout the uvea and it was not sure whether scleral infiltration could already exist, although the enucleation could also be indicated. However, through the histopathological examination, it could be confirmed that the neoplasm was located only at iris, involving also the ciliary body and Choroid coat without sclera leakage, so there would be no need for exenteration. The average age of the patients is around nine years old according to published reports, namely older animals as the patient here described. The orbital exenteration technique, with good safety margin resection, proved to be efficient for the surgical treatment of iris Melanoma involving the ciliary body

Jerry A. Shields - One of the best experts on this subject based on the ideXlab platform.

  • Uveal Melanoma: Estimating prognosis
    Wolters Kluwer Medknow Publications, 2015
    Co-Authors: Swathi Kaliki, Carol L. Shields, Jerry A. Shields
    Abstract:

    Uveal Melanoma is the most common primary malignant tumor of the eye in adults, predominantly found in Caucasians. Local tumor control of uveal Melanoma is excellent, yet this malignancy is associated with relatively high mortality secondary to metastasis. Various clinical, histopathological, cytogenetic features and gene expression features help in estimating the prognosis of uveal Melanoma. The clinical features associated with poor prognosis in patients with uveal Melanoma include older age at presentation, male gender, larger tumor basal diameter and thickness, ciliary body location, diffuse tumor configuration, association with ocular/oculodermal melanocytosis, extraocular tumor extension, and advanced tumor staging by American Joint Committee on Cancer classification. Histopathological features suggestive of poor prognosis include epithelioid cell type, high mitotic activity, higher values of mean diameter of ten largest nucleoli, higher microvascular density, extravascular matrix patterns, tumor-infiltrating lymphocytes, tumor-infiltrating macrophages, higher expression of insulin-like growth factor-1 receptor, and higher expression of human leukocyte antigen Class I and II. Monosomy 3, 1p loss, 6q loss, and 8q and those classified as Class II by gene expression are predictive of poor prognosis of uveal Melanoma. In this review, we discuss the prognostic factors of uveal Melanoma. A database search was performed on PubMed, using the terms "uvea," "iris," "ciliary body," "Choroid," "Melanoma," "uveal Melanoma" and "prognosis," "metastasis," "genetic testing," "gene expression profiling." Relevant English language articles were extracted, reviewed, and referenced appropriately

  • american joint committee on cancer classification of posterior uveal Melanoma tumor size category predicts prognosis in 7731 patients
    Ophthalmology, 2013
    Co-Authors: Carol L. Shields, Swathi Kaliki, Minoru Furuta, Enzo Fulco, Carolina Alarcon, Jerry A. Shields
    Abstract:

    Purpose To evaluate the clinical features and prognosis of posterior uveal (ciliary body and Choroid) Melanoma based on the American Joint Committee on Cancer (AJCC) classification (7th edition) of primary tumor (T). Design Retrospective, interventional case series. Participants Seven thousand seven hundred thirty-one patients. Intervention Ocular management including plaque radiotherapy, enucleation, local resection, or laser therapy. Main Outcome Measures Melanoma-related metastasis and death. Results Of 7731 patients with posterior uveal Melanoma, the AJCC classification based on T was category T1 in 3557 (46%), T2 in 2082 (27%), T3 in 1599 (21%), and T4 in 493 (6%). Based on tumor categories T1, T2, T3, and T4, respectively, features that showed significant increase with tumor category included patient age at presentation (57, 58, 58, and 61 years; P P P P P P P P P P Conclusions Based on the AJCC classification, increasing tumor category was associated with older age, larger tumor, and greater incidence of subretinal fluid, hemorrhage, and extraocular extension. Compared with uveal Melanoma classified as T1, the rate of metastasis and death was 2 times greater for T2, 4 times greater for T3, and 8 times greater for T4. The risk for metastasis and death increased 2-fold with each increasing Melanoma category. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.