Jcc 2002 choroid and ciliary body stage apical height basal diameter t1 <=2. viagra 100mg vs. 50mg generic viagra germany 5 mm <=10 mm t1a     no extraocular extension t1b     microscopic extraocular extension t1c     macroscopic extraocular extension t2 >2. viagra for sale viagra 100mg vs. 50mg 5 – 10 mm >10 - 16 mm t2a     no extraocular extension t2b     microscopic extraocular extension t2c     macroscopic extraocular extension t3 >10 mm >16 mm t4 t3 with extraocular extension n n0 or n1 m m0 or m1 iris stage description t1 limited to iris only t1a     <=3 clock hours in size t1b     >3 clock hours in size t1c     with melanomalytic glaucoma t2 extending into ciliary body and/or choroid t2a     with melanomalytic glaucoma t3 extending into sclera t3a     with melanomalytic glaucoma n n0 or n1 m m0 or m1 [edit] pathology spindle cell (30%): type a - best prognosis, 5-yr os rate = 95% type b - intermediate prognosis, 5-yr os rate = 85% mixed cell (65%): contains spindle and epithelioid cells, 5-yr os rate = 83% epithelioid cell (5%): worse prognosis, 5-yr os rate = 60% [edit] treatment overview survival after development of metastatic disease is poor (median 7 months), so main goal of treatment is cure while disease is confined to the eye historically, enucleation was the standard of care; however, as many as 20% cases were clinically misdiagnosed review of data published in 1978 suggested that enucleation may increase risk of metastasis, and subsequent death. buy viagra generic viagra price compare Subsequent analyses challenged this observation, but search for alternative treatments was on retrospective studies in 1980's suggested similar outcomes between radiation therapy (protons or cobalt plaque) and enucleation a randomized trial comparing helium ions and i-125 plaque brachytherapy showed that 70 gy delivered at the i-125 dose rate is insufficient for control the collaborative ocular melanoma study (coms) is a set of clinical trials that was carried out in 1980's - 1990's to evaluate the role of radiation therapy in management of ocular melanoma: small tumors (height 1 - 3 mm, diameter >5 mm) were prospectively observed medium tumors (height 2. buy generic viagra 5 - 10. cheap viagra online 0mm and diameter <=16 mm) were randomized to i-125 plaque brachytherapy (85 gy) compared with enucleation large tumors (height >=10 mm or diameter >=16 mm) were randomized to pre-enucleation ebrt 20/5 vs. buy generic viagra online Enucleation only the coms "small" study showed that with prospective follow-up, overall survival is comparable to general population the coms "medium" randomized trial showed that the overall survival and risk of death from metastatic disease were comparable between enucleation and plaque brachytherapy, establishing plaque brachytherapy as a reasonable primary treatment the coms "large" randomized trial revealed that pre-enucleation rt does not provide a. what happens if women eat viagra generic viagra canada

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