Background: The purpose of this study is to analyze the long-term evolution of patients with small choroidal melanocytic tumors (SCMTs) undergoing observation, and to assess their rate of transformation into melanomas and survival. Methods: A retrospective single-cohort study of patients with SCMTs (1–3 mm in height and 5–10 mm in base) diagnosed from January 1992 to February 2023 was carried out, with observation as the initial treatment. The main criterion for a transformation into melanoma is considered to be an increase in size of more than 1 mm in height and/or more than 1 mm in base measured on an ultrasound/retinography, recorded in two consecutive visits separated by one to three months. Results: 243 patients were included with a mean age of 65.3 years and a mean follow-up of 7.9 years (6 months–27.9 years); 27 patients showed tumor growth. The probabilities of growth at 5, 10, and 15 years are 10%, 14%, and 17%, respectively. Regarding survival, 22 patients died and only 3 deaths were due to melanoma metastasis. Survival rates at 5 and 10 years are 99% and 97%. Conclusions: Observation is a viable therapeutic option for SCMTs, avoiding the side effects of treatment, considering the majority of these tumors do not progress to melanoma. With close monitoring, patients can be treated promptly upon detecting a transformation. Additionally, the findings confirm that small melanocytic tumors can lead to metastatic disease, albeit at a low rate.
背景：本研究旨在分析接受观察的小型脉络膜黑色素细胞肿瘤（SCMTs）患者的长期演变过程，并评估其转化为黑色素瘤的比率及患者生存情况。方法：对1992年1月至2023年2月期间诊断为SCMTs（高度1-3毫米，基底直径5-10毫米）的患者进行回顾性单队列研究，以观察作为初始治疗方案。肿瘤转化为黑色素瘤的主要判定标准为：在间隔1-3个月的连续两次随访中，通过超声/视网膜照相检测到肿瘤高度增加超过1毫米和/或基底直径增加超过1毫米。结果：共纳入243例患者，平均年龄65.3岁，平均随访时间7.9年（范围6个月至27.9年）；其中27例患者出现肿瘤生长。5年、10年和15年的肿瘤生长概率分别为10%、14%和17%。生存分析显示22例患者死亡，其中仅3例死于黑色素瘤转移。5年和10年生存率分别为99%和97%。结论：鉴于大多数SCMTs不会进展为黑色素瘤，观察是此类肿瘤可行的治疗选择，可避免治疗相关副作用。通过密切监测，可在发现肿瘤转化时及时进行治疗。此外，研究结果证实小型黑色素细胞肿瘤虽转移率较低，但仍可能导致转移性疾病。
Long Term Follow-Up Observation in Small Choroidal Melanocytic Tumors
肿瘤(癌症)患者之家