Local resection versus combined local resection and plaque radiotherapy in the treatment of choroidal melanoma.

Purpose: To evaluate the outcome of local resection versus combined local resection and plaque radiotherapy in the treatment of choroidal melanoma.

Methods: We retrospectively analyzed the records of 60 patients (60 eyes) managed by local resection (group 1, 30 patients, external or internal local resection) or combined local resection and plaque radiotherapy (group 2, 30 patients, both Ruthenium-106 or Cobalt-60), among the 364 melanomas treated at our Department of Ophthalmology, between January 1980 and December 2006. Main outcomes measures were postsurgical complications, visual acuity, local recurrence, reasons for enucleation, and development of metastasis.

Results: The 2 groups of patients were considered sufficiently homogeneous as regards location, cell type, and age. Mean follow-up was 7 years. The median largest basal tumor diameter was 9.8 mm and 10.1, and the median tumor thickness was 7.9 mm and 8, respectively, in groups 1 and 2. No statistically significant differences resulted between group 1 and group 2 as regards postsurgical complications (vitreous hemorrhage, retinal detachment, maculopathy, cataract, and optic neuropathy) (p>0.05), visual acuity (p>0.05), local recurrence (p>0.05), reasons for enucleation (p>0.05), or development of metastasis (p>0.05).

Conclusions: No adjunctive benefits from the combined local resection and plaque radiotherapy can be ruled out from our study.