Purpose: This study aimed to explore factors for refusing treatment in patients diagnosed with uveal melanoma and their subsequent clinical course. Methods: This study included patients with uveal melanoma who refused standard of care treatment. Patient-reported reasons and pre-existing mental health diagnoses were assessed. The sociodemographic profile was compared with the controls. Ocular survival, metastasis-free survival (MFS), and overall survival (OS) were calculated. Results: Nine patients with uveal melanoma declined ocular treatment (plaque brachytherapy, n = 7 [78%]; enucleation, n = 2 [22%]). The choroidal melanomas were small (n = 1 [11%]), medium (n = 5 [56%]), and large (n = 3 [33%]) in size (COMS criteria). The sociodemographic profile of the study patients was not different from those that accepted treatment. One patient (11%) had pre-existing mental health diagnosis. Five patients (56%) eventually accepted treatment following an average delay of 19 months (range: 4–55 months) due to neovascular glaucoma or severe vision loss. MFS could not be ascertained, and OS was 67% (6/9) at 4.2 years of follow-up (mean). Conclusions: Refusal of initial recommended treatment is associated with poor ocular survival. The small sample size did not allow for an evaluation of the impact on survival.
Ocul Oncol Pathol

中文翻译：

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葡萄膜黑色素瘤：拒绝治疗

目的：本研究旨在探讨诊断为葡萄膜黑色素瘤的患者拒绝治疗的因素及其后续临床过程。方法：本研究包括拒绝标准护理治疗的葡萄膜黑色素瘤患者。评估了患者报告的原因和先前存在的心理健康诊断。将社会人口学资料与对照组进行比较。计算眼部生存期、无转移生存期（MFS）和总生存期（OS）。结果： 9 名葡萄膜黑色素瘤患者拒绝接受眼部治疗（斑块近距离放射治疗， n = 7 [78%]；眼球摘除术， n = 2 [22%]）。脉络膜黑色素瘤很小（ n = 1 [11%]），中等（ n= 5 [56%])，并且大小 ( n = 3 [33%]) 大（COMS 标准）。研究患者的社会人口学特征与接受治疗的患者没有区别。一名患者 (11%) 已有心理健康诊断。由于新生血管性青光眼或严重视力丧失，5 名患者 (56%) 在平均延迟 19 个月（范围：4-55 个月）后最终接受了治疗。MFS 无法确定，在 4.2 年的随访（平均）时，OS 为 67%（6/9）。结论：拒绝最初推荐的治疗与较差的眼部存活率相关。小样本量不允许评估对生存的影响。
眼肿瘤病理