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Ocular Melanoma Metastatic to the Liver
If you have been diagnosed with Ocular Melanoma and are considering enucleation, please read this.
For many years, enucleation has been the accepted treatment for ocular melanoma. Research has indicated that enucleation does not improve the patient's life expectancy. Unless you have great pain, there probably is a better treatment for you. Please get a 2nd, 3rd etc. opinion before having your eye removed.
Radiation, Eye Removal Produce Same Survival Rates For Ocular Melanoma
BETHESDA, MD -- July 13, 2001 -- Researchers have found that the survival rates for two alternative treatments for primary eye cancer - radiation therapy and removal of the eye -- are about the same.
Prior to this finding, there was a question in the medical community as to whether either treatment might result in lower mortality. Also, as a consequence of this research, the capability of doctors nationwide to provide more accurate diagnoses and state-of-the-art treatments for eye cancer has been greatly expanded. Mortality data are compared in the July 2001 issue of Archives of Ophthalmology.
Article: Collaborative Ocular Melanoma Study (NIH Website) Excerpt:
The Randomized Trial of Pre-Enucleation Radiation for Large Choroidal Melanoma
Initial mortality findings published in 1998 (COMS Report No. 10) showed that patients with large choroidal melanoma had similar survival rates regardless of whether they were treated with radiation prior to removal of the eye or had their eye removed without prior radiation therapy. Five-year survival rates were approximately 60 percent in both treatment arms. The COMS large tumor trial found neither benefit nor harm from treating ocular melanoma patients with radiation before removal of the eye. However, patients who had pre-enucleation radiation had fewer local complications (COMS Report No. 11).
The Randomized Trial of I-125 Brachytherapy for Medium Choroidal Melanoma
Initial mortality findings published in 2001 (COMS Report No. 18) showed that survival rates for radiation therapy (I-125 brachytherapy) and enucleation (removal of the eye) are about the same. The five-year survival rate of patients who were treated with either radiation therapy or eye removal was 82 percent, considerably better than the 70 percent five-year survival rate that had been projected when the study was designed in 1985. Compared to immediate loss of vision when the eye is removed, eyes treated with radiation steadily lost vision gradually, with 63 percent having visual acuity of 20/200 or worse by three years after treatment (COMS Report No. 16).
From ARCH OPHTHALMOL/Vol.119, Dec. 2001: Angiostatin Produced by Certain Primary Uveal Melanoma Cell Lines Impedes the Development of Liver Metastases Arch opthalmol. 2001;119:1805-1809 Conclusion: By removing a source of angiostatin, enucleation of melanoma-containing eyes may unwittingly exacerbate the metastatic potential of uveal melanoma.
Article may be purchased here: http://www.archophthalmol.com
More info on treatment options is here (2012):
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Ocular Melanoma Metastatic to the Liver
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