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Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/228777
Endoresection in Choroidal Melanoma: Outcomes of Intentional Incomplete Tumor Removal
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To assess the outcomes of a modified surgical approach for the treatment of uveal melanoma involving endoresection with intentional residual tumor at the margins, combined with adjuvant ruthenium-106 brachytherapy. This technique aims to reduce surgical morbidity, while preserving visual function and maintaining effective local tumor control and survival. We conducted a retrospective observational study including 33 patients with choroidal melanoma treated between January 2017 and August 2024 at a single tertiary ocular oncology center in Spain. Patients underwent pars plana vitrectomy and endoresection leaving residual tumor followed by ruthenium-106 brachytherapy. Clinical, functional, and oncological outcomes were analyzed, including tumor recurrence, metastasis, visual acuity, complications, and cytogenetic findings. Kaplan-Meier analysis was used to estimate survival and recurrence rates. After a mean follow-up of 41.7 months, local tumor recurrence occurred in 2 patients (6.06%) and enucleation was performed in 1 patient (3.03%). Two patients (6.06%) developed metastases, with one disease-specific death, resulting in a 5-year survival rate of 97%. Visual acuity of 20/200 or better was preserved in 60.61% of patients. The most frequent complications were retinal detachment (36.36%) and macular edema (45.45%). Cytogenetic analysis showed a significant association between chromosome 1p loss and both recurrence and metastasis (p = 0.032). No cases of phthisis bulbi or severe hypotony were observed. This modified endoresection technique with intentional tumor residuals and adjuvant ruthenium-106 brachytherapy offers a safe and function-preserving option for selected patients with choroidal melanoma. It achieves good tumor control and visual outcomes, with a low rate of enucleation and metastasis. Further studies are required to validate its long-term efficacy.
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ANDUAGA BERAMENDI, Alexander, CAMINAL CARAMÉS, Marta, LORENZO PARRA, Daniel, COBOS MARTÍN, Estefanía, MATEOS OLIVARES, Milagros, GARCÍA BRU, Pere, MORWANI, Rahul, SANTAMARÍA ÁLVAREZ, Juan francisco, GARCIA GARCIA, Olga, ARIAS BARQUET, Lluís, CAMINAL MITJANA, Josep maria. Endoresection in Choroidal Melanoma: Outcomes of Intentional Incomplete Tumor Removal. _Current Oncology_. 2025. Vol. 32, núm. 12. [consulta: 3 de maig de 2026]. ISSN: 1198-0052. [Disponible a: https://hdl.handle.net/2445/228777]