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Controversy is simmering over whether enucleation, which has been the treatment of choice for uveal melanomas for more than a century, may actually accelerate dissemination of tumor cells from this cancer. In one of the latest developments, Washingtonton, DC, researchers—after a retrospective study of 2,652 cases—suggest this may be the case.
If this proves true, the lessons may be several and widely applicable.
Lorenz E. Zimmerman, MD, told a Research to Prevent Blindness seminar in Los Angeles that, as he and co-workers interpret the data, there should be:
reassessment of enucleation as the conventional means of treating malignant melanoma of the uvea;
acquisition of more information about the natural course of such cancers when untreated;
changes in therapy, perhaps including irradiation of the tumor before and/or after surgery to "sterilize" the tumor site and modification of surgical technique to minimize trauma (Arch Ophthalmol 95:1616-1620, 1977).
Zimmerman, chairman of the Department of
What therapy for uveal melanomas? JAMA. 1980;243(7):627–631. doi:10.1001/jama.1980.03300330007007
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