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Open AccessArticle

The MOLES System for Planning Management of Melanocytic Choroidal Tumors: Is It Safe?

1
Ocular Oncology Service, Moorfields Eye Hospital, London EC1V 2PD, UK
2
Ocular Oncology Clinic, Royal Victorian Eye and Ear Hospital, Melbourne VIC 3002, Australia
3
NIHR Biomedical Research Centre for Ophthalmology, University College London Institute of Ophthalmology, London EC1V 9EL, UK
4
Nuffield Laboratory of Ophthalmology, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(5), 1311; https://doi.org/10.3390/cancers12051311
Received: 27 April 2020 / Revised: 18 May 2020 / Accepted: 19 May 2020 / Published: 21 May 2020
Purpose: To evaluate the MOLES system for identifying malignancy in melanocytic choroidal tumors in patients treated for choroidal melanoma. Methods: Records of 615 patients treated for choroidal melanoma between January 2017 and December 2019 were reviewed. Patients were excluded if iris and/or ciliary body involvement (106 patients), inadequate fundus photography (26 patients), no images available for review (21 patients) and/or treatment was not primary (11 patients). Demographic data and AJCC TNM Stage were collected. Color fundus and autofluorescence photographs (FAF), optical coherence tomography (OCT) and B-scan ultrasounds were prospectively reviewed. MOLES scores were assigned according to five criteria: mushroom shape, orange pigment, large size, enlarging tumor and subretinal fluid. Results: A total of 451 patients (mean age, 63.9 ± 13.9 years) were included. At treatment, mean largest basal tumor diameter (LBD) and thickness were 10.3 ± 2.8 mm (range, 3.0–23.0) and 4.3 mm (range, 1.0–17.0). All but one (0.2%) had MOLES scores of ≥3. Eighty-two patients were treated after surveillance lasting a mean of 1.5 years. Initially, most (63/82; 76.8%) had a MOLES score ≥ 3. Importantly, none of the 451 tumors had a score of <2, and as such, the MOLES protocol would have indicated referral to an ocular oncologist for 100% of patients. Conclusion: The MOLES scoring system is a sensitive (99.8%) tool for indicating malignancy in melanocytic choroidal tumors (MOLES ≥ 3). If the examining practitioner can recognize the five features suggestive of malignancy, MOLES is a safe tool to optimize referral of melanocytic choroidal tumors for specialist care. View Full-Text
Keywords: choroidal nevi; choroidal melanoma; scoring system choroidal nevi; choroidal melanoma; scoring system
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MDPI and ACS Style

Roelofs, K.A.; O’Day, R.; Al Harby, L.; Arora, A.K.; Cohen, V.M.L.; Sagoo, M.S.; Damato, B. The MOLES System for Planning Management of Melanocytic Choroidal Tumors: Is It Safe? Cancers 2020, 12, 1311. https://doi.org/10.3390/cancers12051311

AMA Style

Roelofs KA, O’Day R, Al Harby L, Arora AK, Cohen VML, Sagoo MS, Damato B. The MOLES System for Planning Management of Melanocytic Choroidal Tumors: Is It Safe? Cancers. 2020; 12(5):1311. https://doi.org/10.3390/cancers12051311

Chicago/Turabian Style

Roelofs, Kelsey A.; O’Day, Roderick; Al Harby, Lamis; Arora, Amit K.; Cohen, Victoria M.L.; Sagoo, Mandeep S.; Damato, Bertil. 2020. "The MOLES System for Planning Management of Melanocytic Choroidal Tumors: Is It Safe?" Cancers 12, no. 5: 1311. https://doi.org/10.3390/cancers12051311

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