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      Comparison of Tumor Size and Gene Expression at Presentation in Uveal Melanoma Patients before and during the COVID-19 Pandemic

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          Abstract

          Introduction

          The aim of this study was to compare the clinical and gene expression variables of uveal melanoma patients presenting before and after the start of the COVID-19 pandemic as surrogate markers in order to assess the pandemic's potential impact on care.

          Methods

          We conducted a retrospective chart review of uveal melanoma patients at Retina Consultants of Texas and assessed tumor size, staging, and gene expression data during two time periods: May 2019 to February 2020 (Group 1: Before the COVID-19 pandemic declaration by the WHO in March 2020) and May 2020 to March 2021 (Group 2: After the start of the COVID-19 pandemic).

          Results

          A total of 80 patients with uveal melanoma were studied (Group 1: 40 [50%] and Group 2: 40 [50%]). There was no statistically significant difference in the tumor thickness ( p = 0.768), largest base dimension ( p = 0.758), Collaborative Ocular Melanoma Study size class ( p = 0.762), and American Joint Committee on Cancer stages ( p = 0.872) between the two groups. Additionally, there was no difference in the tumors' gene expression data including gene expression profile class ( p = 0.587) and PRAME expressivity ( p = 0.861) between the two groups.

          Discussion/Conclusion

          The COVID-19 pandemic had no effect on the presentation of uveal melanoma patients across all tumor characteristics including size, staging, and gene expression data, suggesting there was not a significant diagnostic delay in care for uveal melanoma patients at our center due to the pandemic.

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          Most cited references32

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          Uveal melanoma: relatively rare but deadly cancer

          Uveal melanoma: relatively rare but deadly cancer
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            Spatial analysis and GIS in the study of COVID-19. A review

            This study entailed a review of 63 scientific articles on geospatial and spatial-statistical analysis of the geographical dimension of the 2019 coronavirus disease (COVID-19) pandemic. The diversity of themes identified in this paper can be grouped into the following categories of disease mapping: spatiotemporal analysis, health and social geography, environmental variables, data mining, and web-based mapping. Understanding the spatiotemporal dynamics of COVID-19 is essential for its mitigation, as it helps to clarify the extent and impact of the pandemic and can aid decision making, planning and community action. Health geography highlights the interaction of public health officials, affected actors and first responders to improve estimations of disease propagation and likelihoods of new outbreaks. Attempts at interdisciplinary correlation examine health policy interventions for the siting of health/sanitary services and controls, mapping/tracking of human movement, formulation of appropriate scientific and political responses and projection of spatial diffusion and temporal trends. This review concludes that, to fight COVID-19, it is important to face the challenges from an interdisciplinary perspective, with proactive planning, international solidarity and a global perspective. This review provides useful information and insight that can support future bibliographic queries, and also serves as a resource for understanding the evolution of tools used in the management of this major global pandemic of the 21 Century. It is hoped that its findings will inspire new reflections on the COVID-19 pandemic by readers.
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              Very long-term prognosis of patients with malignant uveal melanoma.

              To investigate the very long-term prognosis of patients with uveal melanoma and the clinical characteristics influencing it. Charts, registry data, and histopathologic specimens of 289 consecutive patients with choroidal and ciliary body melanoma treated in the district of the Helsinki University Central Hospital, Finland, between 1962 and 1981 were audited. Definitions for coding the cause of death were adapted from the Collaborative Ocular Melanoma Study (COMS). Competing risks were taken into account by using cumulative incidence analysis and competing risks regression. Of the 289 patients treated, 239 were deceased at the end of follow-up. The audited cause of death was uveal melanoma in 145 (61%) of them. The median follow-up of the 50 survivors was 28 years. The original histopathologic diagnosis of metastasis and second cancer was correct in 91% of all specimens, but immunohistochemical reassessment changed 10% of biopsy and 7% of autopsy diagnoses. Of 45 positive autopsies, 18% were performed without suspicion of melanoma. Uveal melanoma-related mortality was 31% (95% confidence interval [CI], 26-37) by 5 years, 45% (95% CI, 40-51) by 15 years, 49% (95% CI, 43-55) by 25 years, and 52% (95% CI, 45-58) by 35 years, according to cumulative incidence analysis. Of patients who died of uveal melanoma, 62%, 90%, 98%, and 100% did so within 5, 15, 25, and 35 years, respectively. Between 15 and 35 years, 20% to 33% of deaths were still due to uveal melanoma. By competing risks regression analysis, the hazard ratio was 1.08 (P=0.0012) for each millimeter increase in tumor diameter, 2.27 (P=0.0076) for extraocular growth, and 1.89 (P=0.0011) for ciliary body involvement. Metastatic uveal melanoma was the leading single cause of death throughout the study. Cumulative incidences provide a sound basis for patient counseling and design of trials.
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                Author and article information

                Journal
                Ocul Oncol Pathol
                Ocul Oncol Pathol
                OOP
                Ocular Oncology and Pathology
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                2296-4681
                2296-4657
                9 May 2022
                9 May 2022
                : 1-5
                Affiliations
                [1] aDepartment of Ophthalmology, University of Texas at Houston, Houston, Texas, USA
                [2] bRetina Consultants of Texas, Houston, Texas, USA
                [3] cHouston Methodist Cancer Center, Houston Methodist Hospital, Houston, Texas, USA
                [4] dDepartment of Radiation Oncology, Houston Methodist Hospital, Houston, Texas, USA
                Author notes
                Article
                oop-0018-0001
                10.1159/000524918
                9372456
                36923229
                0429c5b5-9baf-428f-bc29-7a6236ae128d
                Copyright © 2021 by S. Karger AG, Basel

                This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.

                History
                : 23 January 2022
                : 22 April 2022
                Page count
                Tables: 1, References: 16, Pages: 5
                Categories
                Research Article

                ocular oncology,uveal melanoma,covid-19 pandemic
                ocular oncology, uveal melanoma, covid-19 pandemic

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