SAFETY AND OUTCOME OF TRANSSCLERAL FINE-NEEDLE ASPIRATION BIOPSY IN UVEAL MELANOMA

Purpose: To report safety outcomes of transscleral fine-needle aspiration biopsy (FNAB) followed by irradiation for uveal melanoma (UM) in a tertiary ocular oncology center over 10 years, and assess whether FNAB modified the overall prognosis of patients treated for primary UM. Methods: Patients treated for UM between 2009 and 2020, eligible for conservative treatments by proton beam radiotherapy or Iodine-125 brachytherapy and to FNAB performed before UM treatment (tumor thickness 5–10 mm), were included retrospectively. Patients who underwent FNAB were compared with nonbiopsied UM controls with similar characteristics, matched 1:1 using a propensity score. Complication rates, including local intraocular and extraocular relapse, metastases, and overall survival, were analyzed. Results: Among 2,813 UM cases, 347 cases who underwent FNAB were matched to 347 controls. The median follow-up was 6.1 years (min = 0.2–max=13.3). There was no difference in overall survival (OS) ( P = 0.25) and metastasis-free interval (MFI, P = 0.68). Twenty-four cases (6.9%) and 17 controls (4.9%) developed local intraocular recurrence ( P = 0.46). Extraocular relapses occurred in five cases (1.4%) and one control (0.3%), showing no statistical difference ( P = 0.12). Patients with monosomy 3 and chromosome 8 gain had significantly worse OS and MFI compared with those with normal 3 and 8 chromosomes, and to a lesser extent to those with either chromosomal alteration ( P P = 0.013). Conclusion: FNAB seems safe in extraocular relapses, OS or MFI, but over the 2009 to 2020 period, accessing to primary UM somatic genetic features did not improve patient prognosis.