Fine Needle Aspiration Biopsy in Uveal Melanoma: Technique, Complications, and Outcomes

Am J Ophthalmol. 2016 Feb:162:28-34.e1. doi: 10.1016/j.ajo.2015.11.005. Epub 2015 Nov 10.

Abstract

Purpose: To report the technical aspects, complications, and outcomes concerning fine needle aspiration biopsy (FNAB) in uveal melanoma.

Design: Retrospective cohort study.

Methods: Patients with uveal melanoma who underwent transscleral or transvitreal FNAB at an ocular oncology center were retrospectively evaluated. FNAB was performed if the tumor was more than 5 mm in thickness. Array comparative genomic hybridization analysis was performed on biopsy samples with sufficient tissue. The main outcome measures were success (sample that gave a successful result for biomarker analysis) rate, complications, liver metastasis, and overall survival.

Results: There were 217 (114 male, 52%) consecutive study patients with a mean age of 56.7 (16-84) years. The mean follow-up period was 31 (range 3.6-61.3) months. Mean tumor thickness was 8.4 (range 5-12) mm. The overall success rate of the procedure was 169 patients (77.9%). Thirty-one patients (14.3%) experienced intravitreal hemorrhage, of whom 9 (4.1%) required vitreal surgery. There was no case of endophthalmitis, orbital dissemination, local recurrence, or rhegmatogenous retinal detachment. Thirty-two patients (14.7%) developed metastasis during the study, of whom 20 (9.2%) died. Of the 169 successful samples, 53 patients (31%) were classified as low risk, 41 (24%) as intermediate risk, and 54 (32%) as high risk. Fifteen patients (9%) did not have any detectable chromosomal abnormality and 6 (4%) could not be classified.

Conclusion: FNAB is a relatively safe and successful technique that can be routinely used to obtain tissue for molecular genomic analysis; such analysis helps determine the diagnosis and prognosis in uveal melanoma.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / metabolism
  • Biopsy, Fine-Needle / adverse effects*
  • Biopsy, Fine-Needle / methods*
  • Comparative Genomic Hybridization
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Melanoma / metabolism
  • Melanoma / mortality
  • Melanoma / pathology*
  • Middle Aged
  • Neoplasm Proteins / metabolism
  • Neoplasm Recurrence, Local / pathology
  • Retinal Detachment / diagnosis
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Uveal Neoplasms / metabolism
  • Uveal Neoplasms / mortality
  • Uveal Neoplasms / pathology*

Substances

  • Biomarkers, Tumor
  • Neoplasm Proteins

Supplementary concepts

  • Uveal melanoma