Comparison of high-risk histopathological features in eyes with primary or secondary enucleation for XXXX .

@entity1 @entity66 @entity1781 @entity3 @entity995
AIMS: To compare high-risk histopathology of eyes with primary versus secondary enucleation from @entity1 with @entity995 . @entity1 AND METHODS: A retrospective histopathology review identified 207 eyes enucleated from 202 @entity1 between March 1997 and August 2013. Our review considered high-risk histopathological features to include @entity66 or invasion of the anterior chamber, iris, ciliary body, @entity1781 . RESULTS: Most eyes (144, 70%) were primarily enucleated; 63 (30%) were secondarily enucleated after neoadjuvant therapy. The primary enucleation group had more advanced disease (Reese-Ellsworth group V: 95% vs 59%; International Classification Group D/E: 97% vs 59%; p<0.001). The incidence of high-risk histopathology features was similar between groups (32% vs 21%, n=59; p=0.132). The type of prior therapy was not associated with high-risk histopathology features. Time to enucleation was longer for secondarily enucleated eyes with high-risk features. Choroid and postlaminar optic nerve invasion were more frequent in eyes primarily enucleated (p<0.001). Forty-six of the 59 (78%) @entity1 with high-risk features received adjuvant chemotherapy and/or external beam radiation therapy. Three @entity1 who received primary enucleation and adjuvant therapy died of metastatic recurrence. CONCLUSIONS: Despite the more favourable classification of eyes treated with neoadjuvant therapy, the risk of high-risk histopathology features at enucleation was comparable with eyes undergoing primary enucleation. Delayed enucleation was associated with these features, and the majority of @entity1 required further adjuvant therapy. Caution must be exercised in treating @entity995 to promptly pursue definitive enucleation in an effort to minimise further treatment exposures and @entity3 .
