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Mendes Wefelnberg M, Moll M, von Stein P, Guthoff H, Heindl LM, Wawer Matos Reimer P, Rokohl AC, Simon M, Zubac D, Baumann FT. Eight weeks of exercise intervention improves visuomotor and functional capacity, performance, and physiological profile in a patient with choroidal melanoma. J Appl Physiol (1985) 2024; 136:799-806. [PMID: 38385179 DOI: 10.1152/japplphysiol.00840.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/15/2024] [Accepted: 02/15/2024] [Indexed: 02/23/2024] Open
Abstract
The aim of this case study was to investigate the effects of an 8-wk combined exercise intervention, consisting of visual-coordinative and high-intensity interval training (HIIT), on the physical and visuomotor-functional capacity, performance, and physiological profile of a moderately active 29-yr-old man diagnosed with choroidal melanoma of the left eye. Data were collected on three occasions: at the initial diagnosis (T0), after hospitalization and radiotherapy treatment (T1), and following the recovery through the exercise intervention (T2), spanning a total of 17 wk. The primary outcome variables consisted of visuomotor and functional tests (VFTs), cardiorespiratory fitness (CRF), and microvascular circulation measured via flicker light-induced dilation (FiD). For visuomotor tests in general, a significant decline was observed between baseline T0 and T1 (by 6%-22%), followed by significant improvements at T2 (by 11%-36%), surpassing the initially observed T0 values. The cardiopulmonary exercise testing (CPET)-derived parameters exhibited a similar pattern, declining from T0 to T1 [by 8%-12% for peak V̇o2, peak power output (PO), and CPET duration, respectively], with a subsequent recovery observed in response to 8 wk of exercise training (T2), resulting in increases of 11%-25% for V̇o2, peak PO, and CPET duration. Interestingly, the dilation of both arteries and veins in response to the FiD stimulus exhibited a twofold increase compared with baseline levels. Our results suggest that the 8-wk exercise intervention improved patients' VFT and CRF profiles and exceeded baseline values. Additional investigation, particularly through randomized controlled trials, is needed to comprehensively explain changes in FiD.NEW & NOTEWORTHY Results presented here suggest that combined visual-coordinative and HIIT training improves the visual-functional capacity, performance, and physiological profile of choroidal melanoma patients during treatment recovery. This case study lays the groundwork for further research concerning exercise therapy in this unique patient population. In addition, further investigation is required to fully comprehend the combined effects of exercise and radiation therapy on vasculature and oxygenation in patients with choroidal melanoma.
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Affiliation(s)
- Michael Mendes Wefelnberg
- Department I of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany
| | - Madeline Moll
- Department I of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany
| | - Philipp von Stein
- Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Henning Guthoff
- Clinic III for Internal Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Ludwig M Heindl
- Center for Integrated Oncology Aachen, Bonn, Köln, Düsseldorf, University Cologne, Cologne, Germany
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Philomena Wawer Matos Reimer
- Center for Integrated Oncology Aachen, Bonn, Köln, Düsseldorf, University Cologne, Cologne, Germany
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Alexander C Rokohl
- Center for Integrated Oncology Aachen, Bonn, Köln, Düsseldorf, University Cologne, Cologne, Germany
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Michael Simon
- Center for Integrated Oncology Aachen, Bonn, Köln, Düsseldorf, University Cologne, Cologne, Germany
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Damir Zubac
- Department I of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany
| | - Freerk T Baumann
- Department I of Internal Medicine, Center for Integrated Oncology Aachen, Bonn, Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany
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Huang Y, Guo Y. Quality of life among people with eye cancer: a systematic review from 2012 to 2022. Health Qual Life Outcomes 2024; 22:3. [PMID: 38185647 PMCID: PMC10773080 DOI: 10.1186/s12955-023-02219-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/11/2023] [Indexed: 01/09/2024] Open
Abstract
BACKGROUND Eye cancer is a serious eye disease that threatens patients' lives. In the past decade, there have been more and more studies on eye cancer. From the recently published eye cancer literature review, it can be seen that the two most popular research hotspots are retinoblastoma (RB) and uveal melanoma (UM) [1, 2]. Although several studies have assessed QOL in different types of eye cancer patients, a study that synthesizes the factors influencing QOL in eye cancer patients is yet to be undertaken. This study aimed to review and evaluate the literature related to the QOL of RB and UM survivors, and provide a synthesis of the current evidence on the impact of the two types of eye cancer on the overall QOL of patients. METHODS Eight databases (APA Psych Articles, CINAHL Complete, Health Source: Nursing/Academic Edition, MEDLINE Complete, Scopus, Cochrane Library, PubMed, and Registers (Clinicaltrials.gov.)) were searched between January 2012 and December 2022 for English, peer-reviewed quantitative original studies within this review. All publications were screened using the Preferred Reporting Items for Systematic Review and Meta-Analyses reporting guidelines. The methodological quality of the reviews was assessed using the Joanna Briggs Institute Critical Appraisal Checklists. The findings were summarised and tabulated accordingly. RESULTS Seventeen articles were analysed. Among them, 14 articles on patients with UM, and three articles on patients with RB using 18 different types of measurement tools were included. Eight researchers claimed that the overall QOL of patients with eye cancer was better than or similar to that of the general healthy population. However, nine studies indicated that these patients had poorer QOL than others. Many factors affect QOL, including treatment, sex, and age. CONCLUSION This systematic review identified the QOL levels and several factors that influence the QOL of ocular cancer patients worldwide, due to the variability in quality of the studies, it also showed the need for further research to assess factors affecting long-term QOL outcomes in RB and UM survivors. Simultaneously, it clarified the necessity and importance of developing standardized and complete assessment tools to compare QOL in different countries. Early interventions can be developed to improve the survivors' QOL by identifying potential deficits in specific areas.
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Affiliation(s)
- Yonghui Huang
- Henan Provincial People's Hospital, Henan Provincial Eye Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou University People's Hospital, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, 450003, Henan, China.
| | - Yunfei Guo
- Henan Provincial People's Hospital, Henan Provincial Eye Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou University People's Hospital, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, 450003, Henan, China
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3
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Quigley C, Elshelmani H, Fajin G, Byrne AM, McCloskey C, O'Neill V, Horgan N. Socket outcomes following enucleation for uveal melanoma: post enucleation socket syndrome can be challenging. Eye (Lond) 2024; 38:192-197. [PMID: 37407695 PMCID: PMC10764347 DOI: 10.1038/s41433-023-02657-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 06/22/2023] [Accepted: 06/26/2023] [Indexed: 07/07/2023] Open
Abstract
PURPOSE To evaluate socket outcomes of enucleation for uveal melanoma. METHODS This study was a retrospective chart review conducted in December 2022 of all patients who underwent enucleation surgery for uveal melanoma between 2010 and 2015 in the Royal Victoria Eye and Ear Hospital, to evaluate socket outcomes including completion of revision surgery, type of surgery, and completion of multiple revision surgeries, and potential associations. RESULTS Between June 2010 and December 2015, 72 patients underwent enucleation for uveal melanoma in the ocular oncology service, including 25 females and 47 males, mean age 65, range 11-91 years old. There were 68 primary enucleations and 4 secondary enucleations. Complete follow-up data was available for mean 4 years, range 1-11 years. Fourteen patients underwent further surgery, including one exenteration for local recurrence. Oculoplastic surgery (n = 6, 8%), implant exposure repair (n = 3, 6%), and orbit volume expanding surgery (n = 4, 6%) were also performed. Eight patients (11%) underwent one further surgery and five patients (7%) underwent a series of procedures. There was a significant association with younger age at enucleation (age <65) with undergoing further surgery (p = 0.03, Fisher's Exact Test (FET)), and also an association of younger age with undergoing multiple further surgeries (p = 0.02, FET). There was no association found with other predictor variables, including primary versus secondary enucleation status. Most patients (75%) with PESS underwent more than one surgery. CONCLUSION Post enucleation surgery 82% of patients did not undergo further surgery, but younger patients were more likely to undergo anophthalmic socket revision or oculoplastic surgery. Management of post enucleation socket syndrome was challenging and usually involved a series of procedures.
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Affiliation(s)
- Clare Quigley
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, D02 XK51, Ireland.
| | - Hanan Elshelmani
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, D02 XK51, Ireland
| | - Gabrijela Fajin
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, D02 XK51, Ireland
| | - Aisling McGlacken- Byrne
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, D02 XK51, Ireland
| | - Clare McCloskey
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, D02 XK51, Ireland
| | - Valerie O'Neill
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, D02 XK51, Ireland
| | - Noel Horgan
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, D02 XK51, Ireland
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Banou L, Tsani Z, Arvanitogiannis K, Pavlaki M, Dastiridou A, Androudi S. Radiotherapy in Uveal Melanoma: A Review of Ocular Complications. Curr Oncol 2023; 30:6374-6396. [PMID: 37504330 PMCID: PMC10378371 DOI: 10.3390/curroncol30070470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/20/2023] [Accepted: 07/01/2023] [Indexed: 07/29/2023] Open
Abstract
Uveal melanoma represents the most prevalent form of primary malignant intraocular tumor in adults. Historically, enucleation was considered the gold-standard approach in the treatment of uveal melanoma. Currently, radiotherapy is the most commonly used therapy, aiming at a better quality of life. However, radiotherapy can result in several ocular complications, some of which may be vision-threatening. Radiation-induced dry eye, scleral necrosis, cataract, rubeosis iridis, neovascular glaucoma, radiation retinopathy, maculopathy, and optic neuropathy are the most common complications. This article aims to summarize the current literature regarding the ocular complications after radiotherapy, as well as their clinical features, risk factors, and management strategies. A thorough understanding of these issues is crucial for ophthalmologists and oncologists to provide optimal patient care, improve visual outcomes, and minimize long-term complications.
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Affiliation(s)
- Lamprini Banou
- Department of Ophthalmology, University of Thessaly, 41110 Larissa, Greece
| | - Zoi Tsani
- Department of Ophthalmology, University of Thessaly, 41110 Larissa, Greece
| | | | - Maria Pavlaki
- Department of Ophthalmology, University of Thessaly, 41110 Larissa, Greece
| | - Anna Dastiridou
- Department of Ophthalmology, University of Thessaly, 41110 Larissa, Greece
| | - Sofia Androudi
- Department of Ophthalmology, University of Thessaly, 41110 Larissa, Greece
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5
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Hussain RN, Damato B, Heimann H. Choroidal biopsies; a review and optimised approach. Eye (Lond) 2023; 37:900-906. [PMID: 35941182 PMCID: PMC10050311 DOI: 10.1038/s41433-022-02194-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 07/11/2022] [Accepted: 07/18/2022] [Indexed: 11/09/2022] Open
Abstract
The majority of choroidal tumours are diagnosed accurately with clinical examination and the additional data obtained from non-invasive imaging techniques. Choroidal biopsies may be undertaken for diagnostic clarity in cases such as small melanocytic or indeterminate lesions, identifying the primary tumour in the case of choroidal metastases or the subclassification of rarer conditions such as uveal lymphoma. There is however an increasing use of biopsy techniques for prognostication in uveal melanoma. This review explores the main indications and surgical techniques for tumour acquisition, and the optimised approach utilised by the current authors to improve successful yield for histological and genetic analysis.
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Affiliation(s)
- R N Hussain
- Liverpool Ocular Oncology Centre, Royal Liverpool Hospital, Liverpool, L7 8XP, UK.
| | - B Damato
- Ocular Oncology Service, Moorfields Eye Hospital, London, EC1V 2PD, UK
- NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, EC1V 2PD, UK
| | - H Heimann
- Liverpool Ocular Oncology Centre, Royal Liverpool Hospital, Liverpool, L7 8XP, UK
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Predictors of emotional distress in uveal melanoma survivors: a systematic review. Eye (Lond) 2022; 37:907-924. [PMID: 35941183 PMCID: PMC10049992 DOI: 10.1038/s41433-022-02193-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 07/01/2022] [Accepted: 07/18/2022] [Indexed: 11/08/2022] Open
Abstract
Uveal melanoma (UM) survivors can experience significant emotional distress, although the factors underpinning this are poorly understood. Systematic reviews of distress in UM only include cross-sectional studies, thereby limiting our understanding of causal factors. This review identified prospective clinical, demographic, social and psychological predictors of distress in UM survivors. A systematic search of the literature for English language prospective studies was conducted. Thirteen papers, reporting data from seven unique datasets were included in a narrative synthesis of the results. Younger age (3 studies from 3 datasets), physical health (including visual impairment, ocular symptoms, and other UM-related factors; 3 studies from 3 datasets), and psychological factors (mainly baseline distress; 3 studies from 3 datasets and worry about recurrence; 2 studies from 2 datasets), significantly predicted distress. There was no consistent evidence for other demographic, clinical or social variables (significant in <50% of datasets). Generally, the quality of the papers was adequate. However, attrition rates were high or not reported in over half of the included studies. The findings of this review emphasise the importance of attempts to prevent and recognise distress immediately post-diagnosis of UM. Particular focus should be given to younger patients, those with physical and psychological health difficulties at the time of diagnosis, and those who develop adverse treatment symptoms during survivorship. More research into potential social and psychological variables and their role in predicting distress in survivors is recommended.
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7
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Prognostic and Functional Analysis of NPY6R in Uveal Melanoma Using Bioinformatics. DISEASE MARKERS 2022; 2022:4143447. [PMID: 35432628 PMCID: PMC9012612 DOI: 10.1155/2022/4143447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 03/02/2022] [Accepted: 03/05/2022] [Indexed: 12/14/2022]
Abstract
Neuropeptides can mediate tumor cell proliferation and differentiation through autocrine, paracrine, neurosecretory, and endocrine mechanisms. This study investigated the expression and prognostic significance of neuropeptide Y receptor Y6 (NPY6R) in uveal melanoma (UVM) and preliminarily investigated the biological function of NPY6R in UVM. NPY6R was poorly expressed in most tumors and was associated with better prognosis in UVM. Among the clinicopathological features of UVM, NPY6R expression was lower in male patients. The area under the curve (AUC) value of NPY6R for the diagnosis of UVM was 0.676 (95% CI: 0.556–0.795). A nomogram including four clinical predictors was constructed. NPY6R expression was significantly associated with features of the UVM immune microenvironment. ESTIMATE and CIBERSORT algorithms were used to calculate the fraction of immune cells and the percentage of infiltration in each patient, respectively. NPY6R expression-related gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and gene set enrichment analyses were performed. GO and KEGG enrichment analyses revealed that NPY6R-related genes are mainly enriched in pathways and functions related to visual light perception. Gene set enrichment analysis suggested that NPY6R is associated with tumor progression in UVM. NPY6R is involved in the tumor progression of UVM and has a good predictive value as a prognostic marker of UVM.
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Beenakker JWM, Brouwer NJ, Chau C, Coupland SE, Fiorentzis M, Heimann H, Heufelder J, Joussen AM, Kiilgaard JF, Kivelä TT, Piperno-Neumann S, Rantala ES, Romanowska-Dixon B, Shields CL, Willerding GD, Wheeler-Schilling T, Scholl HPN, Jager MJ, Damato BE. Outcome Measures of New Technologies in Uveal Melanoma: Review from the European Vision Institute Special Interest Focus Group Meeting. Ophthalmic Res 2022; 66:14-26. [PMID: 35358966 DOI: 10.1159/000524372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/22/2022] [Indexed: 11/19/2022]
Abstract
Uveal melanoma (UM) is the most common primary intraocular tumor in adults. New diagnostic procedures and basic science discoveries continue to change our patient management paradigms. A recent meeting of the European Vision Institute (EVI) special interest focus group was held on "Outcome Measures of New Technologies in Uveal Melanoma," addressing the latest advances in UM, starting with genetic developments, then moving on to imaging and treatment of the primary tumor, as well as to investigating the most recent developments in treating metastases, and eventually taking care of the patient's well-being. This review highlights the meeting's presentations in the context of the published literature.
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Affiliation(s)
- Jan-Willem M Beenakker
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Niels J Brouwer
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Cindy Chau
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Sarah E Coupland
- University of Liverpool, Institute of Systems, Molecular and Integrative Biology, Liverpool, UK
| | | | | | | | - Antonia M Joussen
- Charité - Universitätsmedizin Berlin, Klinik für Augenheilkunde, Berlin, Germany
| | - Jens F Kiilgaard
- Department of Ophthalmology, Rigshospitalet and Glostrup Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Tero T Kivelä
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Elina S Rantala
- Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | | | - Carol L Shields
- The Ocular Oncology Service, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | - Thomas Wheeler-Schilling
- European Vision Institute EEIG, Brussels, Belgium
- Institute for Ophthalmic Research, Tübingen, Germany
| | - Hendrik P N Scholl
- Department of Ophthalmology, University of Basel, Basel, Switzerland
- Institute of Molecular and Clinical Ophthalmology (IOB), Basel, Switzerland
| | - Martine J Jager
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | - Bertil E Damato
- Nuffield Laboratory of Ophthalmology, University of Oxford, John Radcliffe Hospital, Oxford, UK
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9
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Damato B. Improving the quality of life of patients undergoing enucleation. Eye (Lond) 2021; 36:1711. [PMID: 34645962 PMCID: PMC9307573 DOI: 10.1038/s41433-021-01783-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 08/20/2021] [Accepted: 09/20/2021] [Indexed: 11/09/2022] Open
Affiliation(s)
- Bertil Damato
- Nuffield Laboratory of Ophthalmology, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK. .,Ocular Oncology Service, Moorfields Eye Hospital, London, UK.
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10
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Damato B. Do Racial/Ethnic Disparities in Rates of Enucleation for Uveal Melanoma Indicate Poor Quality of Care or Financial Obstacles? JAMA Ophthalmol 2021; 139:487-488. [PMID: 33570558 DOI: 10.1001/jamaophthalmol.2020.6828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Bertil Damato
- Nuffield Laboratory of Ophthalmology, University of Oxford, Oxford, United Kingdom
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11
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Eleuteri A, Rola AC, Kalirai H, Hussain R, Sacco J, Damato BE, Heimann H, Coupland SE, Taktak AFG. Cost-utility analysis of a decade of liver screening for metastases using the Liverpool Uveal Melanoma Prognosticator Online (LUMPO). Comput Biol Med 2021; 130:104221. [PMID: 33516960 DOI: 10.1016/j.compbiomed.2021.104221] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 12/29/2022]
Abstract
This paper outlines a method for cost-utility analysis of liver screening for metastases in patients with posterior uveal melanoma (UM). A semiparametric model of the cumulative incidence of onset of liver metastases was fitted to a retrospective data set of 615 subjects with clinical follow-up with respect to liver surveillance imaging and outcome. The model was internally validated via bootstrap resampling in terms of its discrimination and calibration performance. Receiver operating characteristics (ROC) were derived at different time points. The discrimination performances are consistent across time. The area under the ROC curve at 5 years post treatment was 0.85 [95% CI: 0.81-0.88]. A goodness-of-fit test gives χ2(10)=5.3,p=0.9 demonstrating no evidence against the null hypothesis of zero difference between observed and expected onset of metastatic events. Results showed that at 80% sensitivity, 87% of UM patients will avoid unnecessary radiological scans. This provides potential cost savings of between £46,000 and £97,000 per year to the National Health Service assuming 600 new cases per year.
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Affiliation(s)
- Antonio Eleuteri
- Department of Medial Physics and Clinical Engineering, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L7 8XP, UK
| | - Alda Cunha Rola
- Liverpool Ocular Oncology Research Group, Department of Molecular and Cancer Medicine, University of Liverpool, Liverpool, L7 8TX, UK
| | - Helen Kalirai
- Liverpool Ocular Oncology Research Group, Department of Molecular and Cancer Medicine, University of Liverpool, Liverpool, L7 8TX, UK
| | - Rumana Hussain
- Liverpool Ocular Oncology Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L7 8XP, UK
| | - Joseph Sacco
- Liverpool Ocular Oncology Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L7 8XP, UK
| | - Bertil E Damato
- Liverpool Ocular Oncology Research Group, Department of Molecular and Cancer Medicine, University of Liverpool, Liverpool, L7 8TX, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, OX3 9DU, UK
| | - Heinrich Heimann
- Liverpool Ocular Oncology Centre, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L7 8XP, UK
| | - Sarah E Coupland
- Liverpool Ocular Oncology Research Group, Department of Molecular and Cancer Medicine, University of Liverpool, Liverpool, L7 8TX, UK; Liverpool Clinical Laboratories, Liverpool University Foundation Trust, Liverpool, L69 3GH, UK
| | - Azzam F G Taktak
- Department of Medial Physics and Clinical Engineering, Liverpool University Hospitals NHS Foundation Trust, Liverpool, L7 8XP, UK.
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Brown SL, Fisher PL, Hope‐Stone L, Hussain RN, Heimann H, Damato B, Cherry MG. Predictors of long‐term anxiety and depression in uveal melanoma survivors: A cross‐lagged five‐year analysis. Psychooncology 2020; 29:1864-1873. [DOI: 10.1002/pon.5514] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/12/2020] [Accepted: 07/30/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Stephen L. Brown
- Department of Psychological Sciences University of Liverpool Liverpool UK
| | - Peter L. Fisher
- Department of Psychological Sciences University of Liverpool Liverpool UK
- Clinical Health Psychology Service, Linda McCartney Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
| | - Laura Hope‐Stone
- Department of Psychological Sciences University of Liverpool Liverpool UK
- Clinical Health Psychology Service, Linda McCartney Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
- Liverpool Ocular Oncology Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
| | - Rumana N. Hussain
- Liverpool Ocular Oncology Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
| | - Heinrich Heimann
- Liverpool Ocular Oncology Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
| | - Bertil Damato
- Liverpool Ocular Oncology Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
| | - M. Gemma Cherry
- Department of Psychological Sciences University of Liverpool Liverpool UK
- Clinical Health Psychology Service, Linda McCartney Centre Royal Liverpool and Broadgreen University Hospital NHS Trust UK
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Abstract
Uveal melanoma (UM) is the most common primary intraocular malignancy in adults. UMs are usually initiated by a mutation in GNAQ or GNA11, unlike cutaneous melanomas, which usually harbour a BRAF or NRAS mutation. The annual incidence in Europe and the USA is ~6 per million population per year. Risk factors include fair skin, light-coloured eyes, congenital ocular melanocytosis, ocular melanocytoma and the BAP1-tumour predisposition syndrome. Ocular treatment aims at preserving the eye and useful vision and, if possible, preventing metastases. Enucleation has largely been superseded by various forms of radiotherapy, phototherapy and local tumour resection, often administered in combination. Ocular outcomes are best with small tumours not extending close to the optic disc and/or fovea. Almost 50% of patients develop metastatic disease, which usually involves the liver, and is usually fatal within 1 year. Although UM metastases are less responsive than cutaneous melanoma to chemotherapy or immune checkpoint inhibitors, encouraging results have been reported with partial hepatectomy for solitary metastases, with percutaneous hepatic perfusion with melphalan or with tebentafusp. Better insight into tumour immunology and metabolism may lead to new treatments.
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