Metastatic risk of prognostic fine-needle aspiration biopsy in uveal melanoma patients

Despite the widespread use of fine-needle aspiration biopsy (FNAB) of uveal melanoma (UM) for prognostic purposes, there are still doubts about the safety of this procedure. No analysis of such data can be found in domestic literature, and foreign authors have published only a few papers on this issue. The purpose of this study is to analyze the risk of metastasis in patients with UM during FNAB. Two groups of patients were formed: the main group, where FNAB was performed during brachytherapy (BT) (BT + FNAB) (n = 70), and the control group, where only BT was performed (n = 144). According to the obtained data, the probability of metastases during a 3-year follow-up period did not significantly differ between the two groups (p = 0.22 by Fisher's exact test and p = 0.11 by log-rank test when assessing survival using the Kaplan-Meier method), the relative risk (RR) was 1.43 [95% CI 0.79 to 2.24]. In addition, there was no significant difference in the main clinical outcomes of local treatment associated with worse prognosis: the degree of tumor regression (p = 0.46), extrascleral growth, the need for additional brachytherapy (p = 0.32) or secondary enucleation (p = 0.99). The absence of a significant difference in patient survival between the BT and BT + FNAB groups opens up prospects for a more extensive use of FNAB in patients with UM for prognostic purposes.