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Melanoma: HELP
Articles by Victoria M. L. Cohen
Based on 19 articles published since 2008
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Between 2008 and 2019, V. Cohen wrote the following 19 articles about Melanoma.
 
+ Citations + Abstracts
1 Guideline Uveal Melanoma UK National Guidelines. 2015

Nathan, P / Cohen, V / Coupland, S / Curtis, K / Damato, B / Evans, J / Fenwick, S / Kirkpatrick, L / Li, O / Marshall, E / McGuirk, K / Ottensmeier, C / Pearce, N / Salvi, S / Stedman, B / Szlosarek, P / Turnbull, N / Anonymous4090839. ·Mount Vernon Cancer Centre, Northwood, Middlesex, UK. Electronic address: nathan.pd@gmail.com. · Ocular Oncology Service, St Bartholomew's and Moorfields Eye Hospital, London, UK. · Department Molecular and Clinical Cancer Medicine, University of Liverpool, UK. · OcuMel UK, UK. · Royal Liverpool University Hospital, Liverpool, UK. · University Hospital Aintree, Liverpool, UK. · Patient Representative, UK. · Moorfields Eye Hospital, London, UK. · The Clatterbridge Cancer Centre, NHS Foundation Trust, Liverpool, UK. · Southampton University Hospitals and University of Southampton, UK. · University Hospital Southampton, Southampton, UK. · Royal Hallamshire Hospital, Sheffield, UK. · Southampton University Hospitals, NHS Trust, Southampton, UK. · St Bartholomew's Hospital, UK; Barts Cancer Institute, Queen Mary University of London, London, UK. · Project Manager, London, UK. ·Eur J Cancer · Pubmed #26278648.

ABSTRACT: The United Kingdom (UK) uveal melanoma guideline development group used an evidence based systematic approach (Scottish Intercollegiate Guidelines Network (SIGN)) to make recommendations in key areas of uncertainty in the field including: the use and effectiveness of new technologies for prognostication, the appropriate pathway for the surveillance of patients following treatment for primary uveal melanoma, the use and effectiveness of new technologies in the treatment of hepatic recurrence and the use of systemic treatments. The guidelines were sent for international peer review and have been accredited by NICE. A summary of key recommendations is presented. The full documents are available on the Melanoma Focus website.

2 Review Ocular oncology: advances in retinoblastoma, uveal melanoma and conjunctival melanoma. 2017

Vasalaki, Marina / Fabian, Ido D / Reddy, M Ashwin / Cohen, Victoria M L / Sagoo, Mandeep S. ·UCL Institute of Ophthalmology, Bath Street, London EC1V 9EL, UK. · Retinoblastoma Service, Royal London Hospital, Whitechapel Road, London E1 1BB, UK. · Ocular Oncology Service, Moorfields Eye Hospital, City Road, London EC1V 2PD, UK. · Ocular Oncology Service, St. Bartholomew's Hospital, West Smithfield, London EC1A 7BE, UK. · Paediatric Service, Moorfields Eye Hospital, City Road, London EC1V 2PD, UK. · National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK. ·Br Med Bull · Pubmed #28069617.

ABSTRACT: Background: Retinoblastoma, uveal and conjunctival melanomas are important malignancies within the remit of ocular oncology. Outlined are the diagnostic features and management principles, as well as advancements in the field and current challenges. Sources of data: Original papers, reviews and guidelines. Areas of agreement: Most eyes with retinoblastoma (International Intraocular Retinoblastoma Classification (IIRC) Group A-D) are salvaged, whereas advanced cases (Group E) remain a challenge. Despite a high rate of local tumour control in uveal melanoma, metastatic spread commonly occurs. Conjunctival melanoma is treated by complete resection, but high rates of local recurrence occur, with the possibility of systemic relapse and death. Areas of controversy: Use of the IIRC in retinoblastoma, and systemic screening in melanomas. Growing points: Utilization of novel treatment modalities in retinoblastoma and an increasing understanding of the genetic basis of melanomas. Areas timely for developing research: Improvements in chemotherapy delivery in retinoblastoma and prognostic tests in melanomas.

3 Review Predicting local control of choroidal melanomas following ¹⁰⁶Ru plaque brachytherapy. 2011

Papageorgiou, K I / Cohen, V M L / Bunce, C / Kinsella, M / Hungerford, J L. ·Department of Ophthalmology, Barts and the London NHS Trust, West Smithfield, London, UK. victoria.cohen@bartsandthelondon.nhs.uk ·Br J Ophthalmol · Pubmed #20889528.

ABSTRACT: BACKGROUND: We evaluated the control rate of choroidal melanomas treated with ¹⁰⁶Ru plaque brachytherapy to identify the risk factors associated with local recurrence and lack of response. METHODS: A retrospective review of ¹⁰⁶Ru plaque brachytherapy for patients with choroidal melanoma treated at St Bartholomew's Hospital, London. Survival analysis was used to assess associations between evaluated age, sex, location, foveal proximity, tumour base and height, presence of lipofuscin and subretinal fluid, apex dose, radiation rate and type of plaque with time to local recurrence. Logistic regression analysis was used to assess to evaluate the association between the same set of variables and lack of tumour response. RESULTS: From January 2002 to December 2006 189 patients were treated. The follow-up ranged from 12 to 78 (median 33) months. None of the patients received adjuvant diode laser thermotherapy. The control rate was 85.7% (14 recurred while 13 did not respond). Of the patients who had local recurrence, univariate survival analysis demonstrated an association with younger patients, foveal proximity, preoperative subfoveal fluid and tumour base >11 mm. Age and foveal proximity remained significant in a Cox multiple variable model (p=0.03). Of the patients who did not respond, logistic regression analysis showed that lack of response was associated with a tumour height >5 mm, confirmed through multiple variable analysis (p=0.027). CONCLUSIONS: Tumours that are close to the fovea in young patients appear more likely to show local recurrence. Tumour height >5 mm was the only prognostic factor that determined lack of response. These results may be used to select which tumours require adjuvant therapy.

4 Clinical Trial Primary photodynamic therapy with verteporfin for small pigmented posterior pole choroidal melanoma. 2017

Fabian, I D / Stacey, A W / Papastefanou, V / Al Harby, L / Arora, A K / Sagoo, M S / Cohen, V M L / Anonymous2001012. ·Ocular Oncology Service, Moorfields Eye Hospital, London, UK. · Department of Ophthalmology, University of Washington, Seattle, Washington, USA. · University College London Institute of Ophthalmology, London, UK. ·Eye (Lond) · Pubmed #28338667.

ABSTRACT: PurposeThe purpose of the study was to investigate the outcomes of primary photodynamic therapy (PDT) for small pigmented posterior pole choroidal melanoma.Patients and methodsProspective interventional consecutive case series of 15 patients with small pigmented posterior pole choroidal melanoma, who were treated with three sessions of PDT and followed-up thereafter. Risk factors for failure were assessed and outcome measures at presentation were compared to those at last follow-up visit.ResultsTumor control was achieved in 12 (80%) patients in a median follow-up time of 15 months (mean 14, range 8-18). Three patients failed treatment, diagnosed in a median time of 5 months (mean 4, range 3-6), after first PDT. In all failed cases, lesions were 100% pigmented; de novo melanoma rather than transformed nevi and showed a radial growth pattern rather than increased thickness. All failed cases were subsequently successfully treated with radiotherapy. In this cohort, subretinal fluid (SRF) was significantly reduced (P<0.001), vision did not deteriorate (P=0.11) and even improved in patients with subfoveal SRF at presentation (P=0.018), tumor height significantly decreased (P=0.037) and no complications were recorded.ConclusionPrimary PDT was found to be a safe and efficient treatment modality for small pigmented posterior pole choroidal melanoma, achieving short-term tumor control in 80% of patients. PDT offers patients the opportunity to preserve vision by avoiding the retinopathy associated with conventional radiation treatments for choroidal melanoma. However, the long-term local control of these tumors remains uncertain.

5 Clinical Trial Adjuvant Dendritic Cell Vaccination in High-Risk Uveal Melanoma. 2016

Bol, Kalijn F / van den Bosch, Thomas / Schreibelt, Gerty / Mensink, Hanneke W / Keunen, Jan E E / Kiliç, Emine / Japing, Wouter J / Geul, Kaspar W / Westdorp, Harm / Boudewijns, Steve / Croockewit, Sandra A J / van Rossum, Michelle M / de Goede, Anna L / Naus, Nicole C / van der Graaf, Winette T A / Gerritsen, Winald R / de Klein, Annelies / Punt, Cornelis J A / Figdor, Carl G / Cohen, Victoria M / Paridaens, Dion / de Vries, I Jolanda M. ·Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands; Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands. · Department of Ocular Oncology, Rotterdam Eye Hospital, Rotterdam, The Netherlands. · Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands. · Department of Ocular Oncology, Rotterdam Eye Hospital, Rotterdam, The Netherlands; Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, The Netherlands. · Department of Ophthalmology, Radboud University Medical Centre, Nijmegen, The Netherlands. · Department of Ophthalmology, Erasmus Medical Centre, Rotterdam, The Netherlands. · Department of Ophthalmology, University Medical Center Groningen, Groningen, The Netherlands. · Department of Internal Medicine, Sint Franciscus Hospital, Rotterdam, The Netherlands. · Department of Hematology, Radboud University Medical Centre, Nijmegen, The Netherlands. · Department of Dermatology, Radboud University Medical Centre, Nijmegen, The Netherlands. · Department of Pharmacy, Radboud University Medical Centre, Nijmegen, The Netherlands. · Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands; Department of Medical Oncology, The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, United Kingdom. · Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands. · Department of Clinical Genetics, Erasmus Medical Centre, Rotterdam, The Netherlands. · Department of Medical Oncology, Academic Medical Center, Amsterdam, The Netherlands. · Department of Ophthalmology, Moorfields Eye Hospital and St. Bartholomew's Hospital, London, United Kingdom. · Department of Ocular Oncology, Rotterdam Eye Hospital, Rotterdam, The Netherlands; Department of Ophthalmology, Erasmus Medical Centre, Rotterdam, The Netherlands. · Department of Tumor Immunology, Radboud Institute for Molecular Life Sciences, Nijmegen, The Netherlands; Department of Medical Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands. Electronic address: Jolanda.deVries@radboudumc.nl. ·Ophthalmology · Pubmed #27476772.

ABSTRACT: -- No abstract --

6 Clinical Trial Prospective study of sentinel lymph node biopsy for conjunctival melanoma. 2013

Cohen, Victoria M L / Tsimpida, Maria / Hungerford, John L / Jan, Hikmat / Cerio, Rino / Moir, Graeme. ·Department of Ocular Oncology, St Bartholomew's Hospital and Moorfields Eye Hospital London, , London, UK. ·Br J Ophthalmol · Pubmed #24064944.

ABSTRACT: BACKGROUND: To report our experience with sentinel lymph node biopsy for staging patients with conjunctival melanoma. METHODS: A prospective review of patients with conjunctival melanoma who underwent sentinel lymph node biopsy at St Bartholomew's Hospital from May 2008 to May 2012. The selection criterion for sentinel node biopsy depended on the tumour thickness (≥2 mm) and location of the conjunctival melanoma. The main outcome measures were the incidence of sentinel lymph node positivity and the procedure-related complications. RESULTS: In 4 years, 26 out of 70 patients met the selection criteria for sentinel lymph node biopsy. 4 patients declined and 22 patients consented for the procedure. Technetium-99m failed to identify a sentinel lymph node in four of the 22 patients (18%). Of the remaining 18 patients, two were found to have subclinical micrometastasis in regional lymph nodes. Median follow-up was 20 months (range 6-36 months). No false-negative events were observed. Complications of the procedure included transient blue staining of the epibulbar surface in five patients and transient facial nerve palsy in one patient. CONCLUSIONS: Sentinel lymph node biopsy is a safe procedure with minimal complications. It should be considered for the staging of conjunctival melanomas, especially melanomas in non-limbal location or conjunctival melanomas ≥2 mm thick.

7 Article Staging Uveal Melanoma with Whole-Body Positron-Emission Tomography/Computed Tomography and Abdominal Ultrasound: Low Incidence of Metastatic Disease, High Incidence of Second Primary Cancers. 2018

Cohen, Victoria M L / Pavlidou, Efthymia / DaCosta, Joanna / Arora, Amit K / Szyszko, Teressa / Sagoo, Mandeep S / Szlosarek, Peter. ·Ocular Oncology Service, Moorfields Eye Hospital and St Bartholomew's Hospital, London, UK. · NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and University College London Institute of Ophthalmology, London, UK. · Department of Nuclear Medicine, Barts health NHS Trust, London, UK. · Department of Medical Oncology, Barts health NHS Trust, London, UK. ·Middle East Afr J Ophthalmol · Pubmed #30122854.

ABSTRACT: PURPOSE: The purpose of this study was to report the results of staging primary uveal melanoma with whole-body (18) fluorodeoxyglucose (FDG) positron-emission tomography/computed tomography (PET/CT) and abdominal ultrasound. MATERIALS AND METHODS: From January 2012, patients with uveal melanoma over 4 mm in thickness were staged with FDG PET/CT and abdominal ultrasound. RESULTS: Over 2 years, 108 patients with medium-to-large melanoma underwent dual imaging. According to the tumor, node, and metastasis classification, there were 75% T3, 11% T2, and 14% T1 uveal melanomas. Only, three of 108 patients (2.8%) were found to have metastatic uveal melanoma. All three had liver metastases confirmed following biopsy; one of three had additional extrahepatic widespread metastases. In these three patients, liver findings using both imaging techniques were consistent in one patient. In the second case, abdominal ultrasound missed the diagnosis of metastatic disease; however, FDG PET/CT revealed intense metabolic activity of the liver. In the third case, PET/CT missed the liver metastases; however, this was identified on abdominal ultrasound. PET/CT identified incidental second primary malignancies in 10 patients (9%). Second malignancies were found in the lung, breast, colon, thyroid, and adrenal gland. Abdominal ultrasound detected benign hepatic abnormalities in 20 patients (18%). CONCLUSIONS: Whole-body PET/CT and abdominal ultrasound complement each other in the staging of uveal melanoma. Benign hepatic abnormalities found using ultrasound is common. Of importance, a second asymptomatic primary malignancy associated with uveal melanoma was detected almost one in 10 patients.

8 Article Immune privilege: failure of immunotherapy in controlling metastatic cutaneous melanoma to the eye. 2018

Sia, David I T / Thaung, Caroline / O'Hanlon-Brown, Ciara / Cohen, Victoria M L / Sagoo, Mandeep S. ·Moorfields Eye Hospital. · UCL Institute of Ophthalmology, University College London. · Kent and Canterbury Hospital, Kent, UK. · NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital & University College London, London. ·Melanoma Res · Pubmed #29634634.

ABSTRACT: This report concerns a 49-year-old female with cutaneous malignant melanoma and systemic metastases. These resolved following combination immunotherapy with ipilimumab and nivolumab. She subsequently experienced unilateral floaters, an increase in iris pigmentation and pigmentary glaucoma. The eye progressively lost vision and became painful due to iris neovascularization. The clinical diagnosis was of cutaneous melanoma metastatic to the vitreous, ciliary body and iris. Enucleation was performed for symptom control, with histopathology confirming the clinical diagnosis. The immune privilege of the eye may preclude ocular metastasis control with immunotherapy. Ocular symptoms in such patients merit referral to an ophthalmologist.

9 Article Detection of extrascleral extension in uveal melanoma with histopathological correlation. 2018

Burris, Christopher K H / Papastefanou, Vasilios P / Thaung, Caroline / Restori, Marie / Arora, Amit K / Sagoo, Mandeep S / Cohen, Victoria M L. ·a Oculoplastic Surgery , University of South Florida , Tampa, FL, USA. · b Ocular Oncology , St. Bartholomew's Hospital , London , UK. · c Ocular Oncology , Moorfields Eye Hospital , London , UK. · d Eye Pathology , UCL Institute of Ophthalmology , London , UK. · e National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust , London , UK. ·Orbit · Pubmed #29313397.

ABSTRACT: PURPOSE: Uveal melanoma is the most common primary intraocular malignancy. Extrascleral extension (ESE) is rare, but associated with an increased rate of orbital recurrence and an overall poor prognosis. Clinical studies show low rates when compared with histological studies. Due to the prognostic importance of ESE, we sought to compare our clinical, intraoperative, and histological detection rates. DESIGN: A retrospective cross-sectional case series. METHODS: A list of eyes enucleated for uveal melanoma was compiled from the admissions records of the London Ocular Oncology Service during the 28-month period, i.e. January 2010-April 2012. The surgical and clinical notes of patients with histopathology proven ESE were reviewed to determine when it was first diagnosed or suspected. The subsequent management of these cases is discussed. RESULTS: A total of 16 out of 174 (9%) eyes had histologically proven ESE. Eight of 16 cases were detected preoperatively at clinical examination, including the use of ocular ultrasound, 3 of 16 were discovered intra-operatively, and 5 of 16 deemed microscopic ESE, were first detected on histological examination. Seven of 7 (100%) of cases with anterior ESE were detected clinically by slit lamp biomicroscopy, while only 1 out of 9 (11%) of cases with posterior ESE was detected preoperatively with ultrasound. CONCLUSIONS: Slit lamp biomicroscopy is sensitive for detecting anterior ESE. Most posterior ESE is microscopic, but macroscopic posterior ESE may also be missed by B-scan ocular ultrasound. Orbital surgeons should be suspicious of clinically undetected posterior ESE, and consider adjuvant orbital radiotherapy in cases with macroscopic ESE.

10 Article Late Solitary Extraocular Recurrence From Previously Resected Iris Melanoma. 2017

Fabian, Ido Didi / Thaung, Caroline / AlHarby, Lamis / Sisley, Karen / Mudhar, Hardeep S / Doherty, Rachel E / Stacey, Andrew W / Arora, Amit K / Cohen, Victoria M L / Sagoo, Mandeep S. ·Ocular Oncology Service, Moorfields Eye Hospital, London, United Kingdom; Ocular Oncology Service, Goldschleger Eye Institute, Sheba Medical Center, Tel-Aviv University, Tel Aviv, Israel. Electronic address: didifabian@gmail.com. · Ocular Oncology Service, Moorfields Eye Hospital, London, United Kingdom; UCL Institute of Ophthalmology, London, United Kingdom. · Ocular Oncology Service, Moorfields Eye Hospital, London, United Kingdom. · Academic Unit of Ophthalmology & Orthoptics, Department of Oncology & Metabolism, The Medical School, The University of Sheffield, Sheffield, United Kingdom. · National Specialist Ophthalmic Pathology Service, Department of Histopathology, Royal Hallamshire Hospital, Sheffield, United Kingdom. · Ocular Oncology Service, Moorfields Eye Hospital, London, United Kingdom; Department of Ophthalmology, University of Washington, Seattle, Washington. ·Am J Ophthalmol · Pubmed #28673748.

ABSTRACT: PURPOSE: To report on cases of late extraocular relapse of previously resected iris melanoma, without concurrent intraocular recurrence. DESIGN: Retrospective case series. METHODS: A retrospective chart review of 4 patients diagnosed with late subconjunctival relapse of previously resected iris melanoma. RESULTS: Three female patients and 1 male patient underwent iris tumor resection and presented to our service with suspicious conjunctival lesions at a median of 22 years later (mean: 21 years). None showed intraocular relapse. Treatment of the conjunctival tumors included excisional biopsy (n = 4), followed by cryotherapy (n = 3) and/or brachytherapy (n = 3). In all cases, histopathology confirmed malignant melanoma, with no intraepithelial component or associated melanosis. Genetic sequencing (n = 3) showed wild-type BRAF and NRAS in all. GNA11 mutation was found in 1 case. On array-based comparative genomic hybridization (n = 3), gain of 6p was found in 2 cases and gain of 8 in 2. Overall, findings were strongly suggestive of a diagnosis of late extraocular relapse from previously resected iris melanoma. In a median of 2.5 years (mean: 7.7 years) from the subconjunctival relapse, no further episodes of intraocular/extraocular recurrence were recorded, and all patients were free from distant metastasis. CONCLUSIONS: Patients undergoing iris melanoma resection are at risk of developing late solitary extraocular relapse even more than 30 years after surgery. In the absence of an intraocular component, diagnosis may be challenging, as tumors mimic a primary conjunctival lesion. Management by excisional biopsy followed by adjuvant therapy was successful, and histopathology and genetic analysis supported a diagnosis of extraocular uveal tumor spread rather than a primary conjunctival tumor.

11 Article A major responder to ipilimumab and nivolumab in metastatic uveal melanoma with concomitant autoimmunity. 2017

Chan, Pui Ying / Hall, Peter / Hay, Gordon / Cohen, Victoria M L / Szlosarek, Peter W. ·Department of Medical Oncology, St Bartholomew's Hospital, London, UK. · Department of Ocular Oncology, Moorfields Eye Hospital, London, UK. · UCL Institute of Ophthalmology, London, UK. · Department of Ocular Oncology, St Bartholomew's Hospital, London, UK. · Centre for Molecular Oncology, Barts Cancer Institute, London, UK. ·Pigment Cell Melanoma Res · Pubmed #28640512.

ABSTRACT: The use of immune checkpoint inhibition has led to major improvements in outcome for patients with metastatic cutaneous melanoma. The combination of ipilimumab and nivolumab has demonstrated greater activity over single-agent immunotherapy in phase III trials. Clinical trials of combination CTLA-4 and PD-1 inhibition are underway in uveal melanoma, for which there are currently no data. Here, we present the case of a 74-year-old male patient with metastatic uveal melanoma, who was treated with a combination of ipilimumab and nivolumab. He developed sequential autoimmune transaminitis, diabetes and uveitis, which necessitated discontinuation of maintenance nivolumab 3 months after commencement of treatment. The patient continues to demonstrate an ongoing partial response 10 months from the initial combination immunotherapy, with the evidence of depigmentation of the primary ocular tumour.

12 Article MALIGNANT TRANSFORMATION OF A CHOROIDAL NEVUS IN AN EYE TREATED FOR CHOROIDAL MELANOMA. 2017

Fabian, Ido D / Arora, Amit K / Cohen, Victoria M L. ·Ocular Oncology Service, St Bartholomew's and Moorfields Eye Hospitals, London, United Kingdom. ·Retin Cases Brief Rep · Pubmed #27096381.

ABSTRACT: PURPOSE: To report a case of a choroidal melanoma and a discrete choroidal nevus that has transformed into a malignant melanoma 5 years after initial diagnosis. METHODS: Retrospective case report. RESULTS: A diffuse macular choroidal melanoma and a discrete choroidal nevus located superonasal to the optic disk were diagnosed in the right eye of a 63-year-old woman in 2009. The patient was treated by ruthenium plaque radiotherapy for the choroidal melanoma, which consequently flattened and scarred. On a routine eye check in 2014, the nevus was found to have been transformed into a choroidal melanoma. It was treated with ruthenium plaque radiotherapy. CONCLUSION: Although extremely rare, patients with a uveal melanoma can develop an additional discrete uveal melanoma. This case highlights the importance of monitoring benign choroidal nevi in patients with a history of choroidal melanoma.

13 Article The Pediatric Choroidal and Ciliary Body Melanoma Study: A Survey by the European Ophthalmic Oncology Group. 2016

Al-Jamal, Rana'a T / Cassoux, Nathalie / Desjardins, Laurence / Damato, Bertil / Konstantinidis, Lazaros / Coupland, Sarah E / Heimann, Heinrich / Petrovic, Aleksandra / Zografos, Leonidas / Schalenbourg, Ann / Velazquez-Martin, Juan P / Krema, Hatem / Bogdali, Anna / Markiewicz, Anna / Romanowska-Dixon, Bozena / Metz, Claudia H D / Biewald, Eva / Bornfeld, Norbert / Kiratli, Hayyam / Bronkhorst, Inge H G / Jager, Martine J / Marinkovic, Marina / Fili, Maria / Seregard, Stefan / Frenkel, Shahar / Pe'er, Jacob / Salvi, Sachin M / Rennie, Ian G / Rospond-Kubiak, Iwona / Kociecki, Jaroslaw / Kiilgaard, Jens Folke / Heegaard, Steffen / Cohen, Victoria M L / Sagoo, Mandeep S / Amiryan, Anush / Saakyan, Svetlana / Eide, Nils / Krohn, Jørgen / Midena, Edoardo / Parrozzani, Raffaele / Grange, Jean-Daniel / Kilic, Emine / Blasi, Maria Antonietta / Saornil, Maria Antonia / Kivelä, Tero T. ·Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. Electronic address: ranaa.aljamal@hus.fi. · Department of Ophthalmology, Institute Curie, Paris, France. · Ocular Oncology Service, Royal Liverpool University Hospital, Liverpool, United Kingdom. · Ocular Oncology Service, Royal Liverpool University Hospital, Liverpool, United Kingdom; Department of Cellular Pathology, Royal Liverpool University Hospital, Liverpool, United Kingdom. · Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles (FAA), Lausanne, Switzerland. · Department of Ocular Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Canada. · Department of Ophthalmology and Ocular Oncology, Jagiellonian University, Collegium Medicum, Krakow, Poland. · Department of Ophthalmology, Faculty of Medicine, University Duisburg-Essen, Essen, Germany. · Ocular Oncology Service, Department of Ophthalmology, Hacettepe University School of Medicine, Ankara, Turkey. · Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands. · Department of Ophthalmic Oncology, St. Erik's Eye Hospital, Stockholm, Sweden. · Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. · Department of Ophthalmology, Royal Hallamshire Hospital, Sheffield, United Kingdom. · Department of Ophthalmology, Poznán University of Medical Sciences, Poznán, Poland. · Department of Ophthalmology, Copenhagen University Hospital Glostrup, Copenhagen, Denmark. · Ocular Oncology Service, St Bartholomew's and Moorfields Eye Hospital, London, United Kingdom. · Department of Ophthalmic Oncology and Radiology, Helmholtz Institute, Moscow, Russia. · Department of Ophthalmology, Oslo University Hospital-HF and University of Oslo, Oslo, Norway. · Department of Clinical Medicine, Section of Ophthalmology, University of Bergen, Bergen, Norway. · Department of Ophthalmology, University of Padova, Padova, Italy. · G. B. Bietti Foundation, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Ocular Oncology and Toxicology Research Unit, Rome, Italy. · Department of Ophthalmology, Croix-Rousse Hospital, Lyon, France. · Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands. · Department of Ophthalmology, Catholic University of Rome, Rome, Italy. · Department of Ophthalmology, Ocular Oncology Unit, Valladolid University Hospital, Valladolid, Spain. · Ocular Oncology Service, Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland. ·Ophthalmology · Pubmed #26854035.

ABSTRACT: PURPOSE: To collect comprehensive data on choroidal and ciliary body melanoma (CCBM) in children and to validate hypotheses regarding pediatric CCBM: children younger than 18 years, males, and those without ciliary body involvement (CBI) have more favorable survival prognosis than young adults 18 to 24 years of age, females, and those with CBI. DESIGN: Retrospective, multicenter observational study. PARTICIPANTS: Two hundred ninety-nine patients from 24 ocular oncology centers, of whom 114 were children (median age, 15.1 years; range, 2.7-17.9 years) and 185 were young adults. METHODS: Data were entered through a secure website and were reviewed centrally. Survival was analyzed using Kaplan-Meier analysis and Cox proportional hazards regression. MAIN OUTCOME MEASURES: Proportion of females, tumor-node-metastasis (TNM) stage, cell type, and melanoma-related mortality. RESULTS: Cumulative frequency of having CCBM diagnosed increased steadily by 0.8% per year of age between 5 and 10 years of age and, after a 6-year transition period, by 8.8% per year from age 17 years onward. Of children and young adults, 57% and 63% were female, respectively, which exceeded the expected 51% among young adults. Cell type, known for 35% of tumors, and TNM stage (I in 22% and 21%, II in 49% and 52%, III in 30% and 28%, respectively) were comparable for children and young adults. Melanoma-related survival was 97% and 90% at 5 years and 92% and 80% at 10 years for children compared with young adults, respectively (P = 0.013). Males tended to have a more favorable survival than females among children (100% vs. 85% at 10 years; P = 0.058). Increasing TNM stage was associated with poorer survival (stages I, II, and III: 100% vs. 86% vs. 76%, respectively; P = 0.0011). By multivariate analysis, being a young adult (adjusted hazard rate [HR], 2.57), a higher TNM stage (HR, 2.88 and 8.38 for stages II and III, respectively), and female gender (HR, 2.38) independently predicted less favorable survival. Ciliary body involvement and cell type were not associated with survival. CONCLUSIONS: This study confirms that children with CCBM have a more favorable survival than young adults 18 to 25 years of age, adjusting for TNM stage and gender. The association between gender and survival varies between age groups.

14 Article Secondary Enucleations for Uveal Melanoma: A 7-Year Retrospective Analysis. 2015

Fabian, Ido Didi / Tomkins-Netzer, Oren / Stoker, Ian / Arora, Amit K / Sagoo, Mandeep S / Cohen, Victoria M L. ·Moorfields Eye Hospital, London, United Kingdom; St Bartholomew's Hospital, London, United Kingdom. Electronic address: didifabian@gmail.com. · Moorfields Eye Hospital, London, United Kingdom; University College London Institute of Ophthalmology, London, United Kingdom. · St Bartholomew's Hospital, London, United Kingdom. · Moorfields Eye Hospital, London, United Kingdom; St Bartholomew's Hospital, London, United Kingdom. · Moorfields Eye Hospital, London, United Kingdom; St Bartholomew's Hospital, London, United Kingdom; University College London Institute of Ophthalmology, London, United Kingdom. ·Am J Ophthalmol · Pubmed #26344583.

ABSTRACT: PURPOSE: To describe the indications for secondary enucleations in uveal melanoma and analyze associations and outcomes. DESIGN: Retrospective interventional case series. METHODS: Data of patients who underwent secondary enucleation for uveal melanoma in the London Ocular Oncology Service, between 2008 and 2014, were retrieved from medical records analyzed. Cox regression model was performed to analyze associations with secondary enucleation and metastases and Kaplan-Meier estimates to assess the probability of metastatic spread and death. RESULTS: During the study period 515 enucleations were performed for uveal melanoma, 99 (19%) of which were secondary enucleations. Tumors were located at the ciliary body in 21 eyes (21%), juxtapapillary in 31 (31%), and choroid elsewhere in 47 (48%). Primary treatment included Ru(106) plaque radiotherapy, proton beam radiotherapy, and transpupillary thermotherapy in 85, 11, and 3 eyes, respectively. Indications for secondary enucleation were tumor recurrence in 60 (61%), neovascular glaucoma in 21 (21%), and tumor nonresponse in 18 eyes (18%). Twenty patients (20%) were diagnosed with metastasis and 12 out of 20 died of metastatic spread. On multivariate analysis, juxtapapillary tumor location was found to associate with tumor nonresponse (P = .004) and nonresponding patients with metastatic spread (P = .04). CONCLUSIONS: Indications for secondary enucleations for uveal melanoma were tumor recurrence, neovascular glaucoma, and tumor nonresponse. This review identified a possible high-risk group (nonresponse), which proved radioresistant to treatment. These tumors were more frequently found in the juxtapapillary location and were associated with metastatic spread.

15 Article Evaluation of iris and iridociliary body lesions with anterior segment optical coherence tomography versus ultrasound B-scan. 2015

Hau, Scott C / Papastefanou, Vasilios / Shah, Shima / Sagoo, Mandeep S / Restori, Marie / Cohen, Victoria. ·NIHR Biomedical Research Centre in Ophthalmology Moorfields Eye Hospital NHS Foundation Trust, London, UK. · NIHR Biomedical Research Centre in Ophthalmology Moorfields Eye Hospital NHS Foundation Trust, London, UK Ocular Oncology Service, St. Bartholomew's Hospital, London, UK. · NIHR Biomedical Research Centre in Ophthalmology Moorfields Eye Hospital NHS Foundation Trust, London, UK Ocular Oncology Service, St. Bartholomew's Hospital, London, UK UCL Institute of Ophthalmology, London, UK. ·Br J Ophthalmol · Pubmed #25091953.

ABSTRACT: AIMS: To compare anterior segment optical coherence tomography (AS-OCT) with ultrasound B-scan (USB) in evaluating iris and iridociliary body lesions. METHODS: Image features and resolution comparison between AS-OCT and USB in 126 patients (126 eyes) presenting with iris or iridociliary body lesion. Bland-Altman plots were generated to assess the level of agreement between the two techniques. RESULTS: The three most common diagnoses were iris naevi (62 (49.2%)), iris pigment epithelial cysts (23 (18.3%)) and iris melanoma (11 (8.7%)). Image feature comparison for USB was better than AS-OCT in visualising all tumour margins (81 (64.3%) vs 59 (46.8%)), posterior tumour margin (54 (42.9%) vs 16 (12.7%)) and producing less posterior shadowing (121 (96%) vs 43 (34.1%)). Image resolution comparison revealed USB to be slightly better for resolving the overall tumour (45 (35.7%) vs 43 (34.1%)) and posterior tumour surface (70 (55.6%) vs 32 (25.4%)) but AS-OCT was better for resolving the anterior (62 (49.2%) vs 4 (3.2%)) and lateral tumour surface (62 (49.2%) vs 31 (24.6%)). Comparing the three most common diagnoses, USB was better for visualising iris pigment epithelial cysts (12 (52.2%) vs 2 (8.7%)) and iris melanoma (7 (63.6%) vs 1 (9.1%)) but AS-OCT was better (28 (45.2%) vs 15 (24.2%)) for visualising iris naevi. Bland-Altman plots showed good agreement between the two techniques for lesions smaller than 3 mm in base and 2 mm in elevation. CONCLUSIONS: AS-OCT is superior to USB for imaging small lesions pertaining to the anterior iris but USB is better for imaging larger iris lesions with posterior or ciliary body extension.

16 Article Metabolic activity of primary uveal melanoma on PET/CT scan and its relationship with monosomy 3 and other prognostic factors. 2014

Papastefanou, Vasilios P / Islam, Shahriar / Szyszko, Teresa / Grantham, Marianne / Sagoo, Mandeep S / Cohen, Victoria M L. ·Ocular Oncology Service, St Bartholomew's and Moorfields Eye Hospital, London, UK. · Department of Nuclear Medicine, St Bartholomew`s Hospital, London, UK. · Department of Molecular Medicine, Royal London Hospital, London, UK. · Ocular Oncology Service, St Bartholomew's and Moorfields Eye Hospital, London, UK UCL Institute of Ophthalmology, London, UK. ·Br J Ophthalmol · Pubmed #25084771.

ABSTRACT: PURPOSE: To correlate the metabolic activity of primary uveal melanoma on positron emission tomography (PET)/CT scan with known clinical and pathological prognostic factors. METHODS: A retrospective cohort analysis of eyes enucleated for uveal melanoma that underwent preoperative imaging with a PET/CT scan was performed. Tumour dimensions were recorded and classified using Collaborative Ocular Melanoma Study (COMS) and American Joint Committee on Cancer (AJCC) Tumour - Nodes - Metastases (TNM) criteria. Metabolic activity was determined by measurement of the maximal standardised uptake value (SUVmax) on PET/CT scans. SUVmax of >2.5 and >4 was also used as cut-off value for metabolic positivity. Chromosome 3 and 8 status was determined using fluorescence in situ hybridisation analysis. Pearson correlation, χ(2) test and non-parametric tests were used. p<0.05 was considered statistically significant. RESULTS: Seventy-six uveal melanomas were imaged preoperatively with a PET/CT scan. Overall 92% of tumours had a SUVmax >2.5 and 67% had a SUVmax >4. Monosomy 3 was found in 35 melanomas, of which 94% had an SUVmax >2.5 and 80% had an SUVmax >4. Only 57% of disomy 3 melanomas had an SUVmax >4. SUVmax was significantly increased in tumours with monosomy 3 (p=0.043) but not in tumours with chromosome 8 gain (p=0.49). SUVmax and increasing tumour size were positively correlated (p<0.05). Using the AJCC criteria, there was a significant difference in SUVmax among prognostic groups (p=0.024). There was no correlation with histopathological cell type (p=0.923). CONCLUSIONS: Metabolic activity of uveal melanoma on PET/CT scan is positively correlated with monosomy 3, increasing tumour size and TNM prognostic groups. No association with chromosome 8 gain or histopathology cell type was noted. SUVmax >4 is a relative but not an absolute indicator of monosomy 3 status.

17 Article Plaque radiotherapy treatment with ruthenium-106 for iris malignant melanoma. 2011

Tsimpida, M / Hungerford, J / Arora, A / Cohen, V. ·Department of Ophthalmology, St Bartholomew's Hospital and Moorfields Eye Hospital, London, UK. maria.tsimpida@bartsandthelondon.nhs.uk ·Eye (Lond) · Pubmed #21941358.

ABSTRACT: PURPOSE: To report the results of ruthenium-106 plaque radiotherapy for iris malignant melanoma. METHODS: A retrospective study of 15 patients with pure iris melanoma treated with ruthenium-106 plaque radiotherapy from June 1998 to June 2006. The main outcome measures were tumour control and ocular complications. RESULTS: Of the 15 patients, 8 had biopsy-proven melanoma (6 incisional and 2 excisional biopsies). In the remaining seven patients enlargement of the lesion was documented. The median follow-up was 96 months (ranging from 14 months to 12 years). Common radiation-related complications included cataract in 9 (60%) patients, dry eyes in 3 (20%) patients and elevated intraocular pressure in 4 (27%) patients. Vision was preserved in 80% of patients. Local tumour control was obtained in all patients. CONCLUSIONS: Ruthenium-106 plaque radiotherapy is an effective treatment for primary malignant iris melanoma, resulting in excellent local control with preservation of vision. Main complications included cataract, dry eyes, and glaucoma.

18 Minor A conjunctival and choroidal melanoma in the same eye: report of two cases. 2017

Fabian, Ido D / Thaung, Caroline / Cohen, Victoria M L. ·Moorfields Eye Hospital, City Road, London, EC1V 2PD, UK. didifabian@gmail.com. · Ocular Oncology Service, St Bartholomew's Hospital, London, UK. didifabian@gmail.com. · Moorfields Eye Hospital, City Road, London, EC1V 2PD, UK. · UCL Institute of Ophthalmology, London, UK. · Ocular Oncology Service, St Bartholomew's Hospital, London, UK. ·Graefes Arch Clin Exp Ophthalmol · Pubmed #28213628.

ABSTRACT: -- No abstract --

19 Unspecified Extremely Invasive Conjunctival Melanoma. 2016

Fabian, Ido D / Thaung, Caroline / Cohen, Victoria M L. ·Moorfields Eye Hospital, London, England; Ocular Oncology Service, St Bartholomew's Hospital, London, England. · Moorfields Eye Hospital, London, England; UCL Institute of Ophthalmology, London, England. ·Ophthalmology · Pubmed #27450815.

ABSTRACT: -- No abstract --