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首页> 外文期刊>British journal of ophthalmology >Mode of presentation and time to treatment of uveal melanoma in Finland.
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Mode of presentation and time to treatment of uveal melanoma in Finland.

机译：芬兰葡萄膜黑色素瘤的治疗方式和治疗时间。

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AIMS: To investigate the current referral pattern and delays in treatment of patients with primary uveal melanoma. METHODS: 184 consecutive Finnish patients with uveal melanoma diagnosed between July 1994 and June 1999 were eligible, and 159 were enrolled (inclusion rate, 86%). Their mean age was 60 years (range 14-87). The dates of visits to dispensing optician, physician, ophthalmologist and ocular oncologist, the presence of symptoms, and reason for consultation were determined by structured telephone interview. Time intervals to treatment planning and treatment were calculated. RESULTS: 139 patients (87%) had symptoms at presentation and 44 patients (28%) had been seen by an ophthalmologist less than 2 years previously. The median height of the tumour was 6 mm (range, 1.0-17.0) and its largest basal diameter 11 mm (range 2.5-22.0) at diagnosis. Melanoma developed from a previously detected presumed naevus in 13 patients (8%). When the first contact was a dispensing optician (15%) the median time to treatment planning was 22 days (range 1-1156). When a physician other than an ophthalmologist (19%) was contacted the delay was 68 days (range 0-1283) and when an ophthalmologist (65%) was seen it was 34 days (range 1-1426). These differences were not significant (p=0.32). The chance of being referred at first visit was 89%. Median time to treatment was not associated with symptoms (p=0.16) and tumour volume (p=0.29), but it was significantly different between patients who were and were not referred at first visit (140 days v 34 days; p<0.001) and between those treated by ruthenium and iodine brachytherapy (59 days v 33 days; p=0.009). CONCLUSIONS: Analysis of delays in management indicates that earlier treatment could be achieved if dilated fundus examinations were performed without exceptions, all suspicious naevi were referred for a second opinion, and if the patients with melanoma were referred to the ocular oncology service concurrently with staging examinations done at the regional hospital.
机译：目的：调查原发性葡萄膜黑色素瘤患者的当前转诊模式和治疗延迟。方法：1994年7月至1999年6月期间连续诊断出的184例芬兰葡萄膜黑色素瘤患者符合条件，入组159例（纳入率86％）。他们的平均年龄为60岁（范围14-87）。配镜师，医师，眼科医生和眼肿瘤科医生的就诊日期，症状的出现以及会诊的原因均通过结构性电话采访来确定。计算出治疗计划和治疗的时间间隔。结果：139名患者（87％）出现症状，而眼科医生在不到2年的时间内就诊了44例（28％）。在诊断时，肿瘤的中位高度为6毫米（范围1.0-17.0），最大基底直径为11毫米（范围2.5-22.0）。黑色素瘤是由先前发现的13名患者（8％）的痣引起的。当初次接触是配镜师（15％）时，制定治疗计划的中位数时间为22天（范围1-1156）。与眼科医生以外的医师（19％）进行接触时，延迟时间为68天（0-1283范围），而眼科医生（65％）的延迟时间为34天（1-1426范围）。这些差异不明显（p = 0.32）。初诊时被推荐的机会是89％。中位治疗时间与症状（p = 0.16）和肿瘤体积（p = 0.29）无关，但首次就诊和未就诊的患者之间存在显着差异（140天v 34天; p <0.001）在接受钌和碘近距离放射治疗的患者之间（59天对33天; p = 0.009）。结论：延迟治疗的分析表明，如果无例外地进行扩大的眼底检查，将所有可疑的内维转诊至第二意见，并且如果将黑素瘤患者转诊至眼肿瘤科并进行分期检查，则可以实现早期治疗在地区医院做。

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