J.ophthalmol.(Ukraine).2020;3:31-36.

http://doi.org/10.31288/oftalmolzh202033136

Received: 28 February 2020; Published on-line: 24 June 2020



Efficacy of radiowave surgery in the treatment of patients with iris and ciliary body melanoma

A.P. Maletskiy, Dr Sc (Med); O.V. Khomiakova

SI “The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine”; Odesa (Ukraine)

E-mail: maletskiy@filatov.com.ua

TO CITE THIS ARTICLE: Maletskiy A.P., Khomiakova O.V. Efficacy of radiowave surgery in the treatment of patients with iris and ciliary body melanoma. J.ophthalmol.(Ukraine).2020;3:31-36. http://doi.org/10.31288/oftalmolzh202033136


Purpose: To determine the efficacy of resecting iris and ciliary body melanoma with the use of a 3.8-4.0-Mhz radiowave surgery unit.

Material and Methods: This study was conducted at Department of Eye Cancer, the Filatov Institute, from 2005 through 2018. The study group involved 45 patients with iris and ciliary body melanoma; the mean age was 56.3 ± 2.2 years, with a slight female predominance (53.3%). Sixty-seven patients who had undergone iridociliary melanoma excision using a conventional technique with cutting tools were used as retrospective controls. The eye examination included visual acuity measurement, perimetry, biomicroscopy and ophthalmoscopy. Tumor, nodus и metastasis (TNM) staging was according to the American Joint Committee on Cancer (AJCC). No metastases were seen at the time of enrollment. The mean tumor prominence at baseline was 4.0 ± 0.3 mm, with a mean base diameter of 8.3 ± 0.4 mm, corresponding to a tumor volume of 34.3 ± 0.7 mm3. All the patients of each group were divided into two subgroups based on baseline visual acuity. The study group involved subgroup 1A (n=37 patients; 82.2%) with a visual acuity of 0.1 to 0.5 and subgroup 1B (n=8 patients; 17.8%) with a visual acuity of 0.6 to 0.8, and the retrospective control group involved subgroup 2A (n=55 patients; 82.1%) with a visual acuity of 0.1 to 0.5 and subgroup 2B (n=12 patients; 17.9%) with a visual acuity of 0.6 to 0.8 (p > 0.05). The analysis was performed by analysis of variance (ANOVA) using Statistica 13.0 (Dell Statsoft Inc., Austin, TX). 

Results: The radiosurgical approach to treatment of iridociliary tumors in our patients allowed significantly reducing the rates of intraoperative and postoperative complications (?2=4.16; df=1; p=0.04). In addition, the rates of intraoperative and postoperative complications for the treatment of iridociliary tumors with cutting instruments were 9.1% and 10.4%, respectively. The use of a radiowave surgery unit for uveal melanoma resection allowed preserving baseline visual acuity in all patients, with a tumor recurrence rate of not more than 2.2%.

Conclusion: Early (12-month) treatment outcomes (visual functions and postoperative clinical course) and late treatment outcomes (visual functions; optic media; IOP; and tumor recurrence) for iridociliary melanoma resection using a radiowave 3.8-4.0 MHz unit allow us to state that high-frequency radiowave surgery enables reducing the risk of intraoperative and postoperative complications and, consequently, preserving a good visual function.

Keywords: uveal melanoma, radiowave surgery unit, treatment


References

1.Aronow ME, Topham AK, Singh AD. Uveal Melanoma: 5-Year Update on Incidence, Treatment, and Survival (SEER 1973-2013). Ocul Oncol Pathol. 2018 Apr;4(3):145-151.

Crossref  PubMed

2.Papastefanou VP, Cohen VM. Uveal Melanoma.  J Skin Cancer. 2011;2011:1–13.

Crossref   PubMed

3.Shields CL, Kaliki S, Furuta M, et al. American Joint Committee on Cancer Classification of Uveal Melanoma (Anatomic Stage) Predicts Prognosis in 7,731 Patients: The 2013 Zimmerman Lecture. Ophthalmology. 2015 Jun;122(6):1180-6.  C

Crossref   PubMed

4.Kim JH, Shin SJ, Heo SJ, et al. Prognoses and Clinical Outcomes of Primary and Recurrent Uveal Melanoma. Cancer Res Treat. 2017 Dec 28. doi: 10.4143/crt.2017.534.

Crossref   PubMed

5.Chua V, Aplin AE. Novel therapeutic strategies and targets in advanced uveal melanoma. Curr Opin Oncol. 2018 Mar;30(2):134-41.

Crossref   PubMed

6.Khomiakova OV, Vit VV, Maletskyi AP. [Comparing structural changes in the rabbit’s uveal tract after the use of a radiowave surgery unit versus a cutting tool].  J Ophthalmol (Ukraine). 2019;4:43-48. Ukrainian. 

Crossref  

7.Ministry of Health of Ukraine. [Order of Ministry of Health of Ukraine No. 117 “On Approval of Protocols for Provision of Medical Care to Patients with Eye Disease”]. Kyiv, Ukraine; 15 March 2007. https://zakononline.com.ua/documents/show/107241___107241 

8.Rebrova OIu. [Statistical analysis of medical data. Application of STATISTICA software package]. Moscow: MediaSfera. 2002. Russian.

9.Smoliakova GP, Pikhovskaia IG, Luz’ianina IG, Sorokin EL. [Method for radiosurgical treatment of uveal melanoblastoma]. Patent of Russian Federation RU No. 2265423 A61F dated 10.09.2006. Patent owner: Far East State Medical University. Application filed on 20.02.2005. Information Bulletin No. 34 issued 10.12.2005.

10.Yang J, Manson DK, Marr BP, Carvajal RD. Treatment of uveal melanoma: where are we now? Ther Adv Med Oncol. 2018 Feb 21;10:1758834018757175.

Crossref   PubMed

11.Uveal Melanoma. Available at: https://eyewiki.aao.org/Uveal_Melanoma#targetText=Associated%20with%20th....

 

The authors certify that they have no conflicts of interest in the subject matter or materials discussed in this manuscript.