Comparison of clinical outcomes for patients with large choroidal melanoma after primary treatment with enucleation or proton beam radiotherapy

Abstract

Purpose: To evaluate survival and clinical outcome for patients with a large uveal melanoma treated by either enucleation or proton beam radiotherapy (PBRT).

Procedures: This retrospective non-randomized study evaluated 132 consecutive patients with T3 and T4 choroidal melanoma classified according to TNM stage grouping.

Results: Cumulative all-cause mortality, melanoma-related mortality and metastasis-free survival were not statistically different between the two groups (log-rank test, p = 0.56, p = 0.99 and p = 0.25, respectively). Eye retention of the tumours treated with PBRT at 5 years was 74% (SD 6.2%). In these patients at diagnosis, 73% of eyes had a best-corrected visual acuity (BCVA) of 0.1 or better. After 12 and 60 months, BCVA of 0.1 or better was observed in 47.5 and 32%, respectively.

Conclusion and message: Although enucleation is the most common primary treatment for large uveal melanomas, PBRT is an eye-preserving option that may be considered for some patients.