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Thursday 27 February 2020

CCC publication: Effects of Plaque Brachytherapy and Proton Beam Radiotherapy on Prognostic Testing: A Comparison of Uveal Melanoma Genotyped by Microsatellite Analysis

Citation: The British Journal of Ophthalmology. 2020, 104(10), 1462-66. [Online ahead of print 2020 Feb 5]
Author: Sophie Thornton, Sarah E Coupland, Heinrich Heimann, Rumana Hussain, Carl Groenewald, Andrzej Kacperek, Bertil Damato, Azzam Taktak, Antonio Eleuteri, Helen Kalirai
Abstract: Background/aims:  Proton beam radiotherapy and plaque brachytherapy are commonly applied in primary uveal melanoma (UM); however, their effect on chromosome 3 classification of UM by microsatellite analysis (MSA) for prognostication purposes is unknown, where the tumour is sampled post-irradiation. This study examined the prognostic accuracy of genotyping UM biopsied before or after administration of radiotherapy, by MSA.
Methods:  407 UM patients treated at the Liverpool Ocular Oncology Centre between January 2011 to December 2017, were genotyped for chromosome 3 by MSA; 172 and 176 primary UM were sampled prior to and post irradiation, respectively.
Results:  Genotyping by MSA was successful in 396/407 (97%) of UM samples (196 males, 211 females; median age of 61 years (range 12 to 93) at primary treatment). There was no demonstrable association between a failure of MSA to produce a chromosome 3 classification and whether radiation was performed pre-biopsy or post-biopsy with an OR of 0.96 (95% CI 0.30 to 3.00, p=0.94). There was no evidence of association (measured as HRs) between risk of metastatic death and sampling of a primary UM before administration of radiotherapy (HR 1.1 (0.49 to 2.50), p=0.81). Monosomy 3 (HR 12.0 (4.1 to 35.0), p<0.001) was significantly associated with increased risk of metastatic death.
Conclusions and relevance:  This study revealed that successful genotyping of UM using MSA is possible, irrespective of irradiation status. Moreover, we found no evidence that biopsy prior to radiotherapy increases metastatic mortality.
Keywords:  diagnostic tests/investigation; eye (globe); genetics; iris; neoplasia.

Link to PubMed record