Uveal melanoma (UM) is an aggressive intraocular tumor with a high propensity to metastasize. Accurate prognostication is relevant for patient counselling, planning of follow-up and... Show moreUveal melanoma (UM) is an aggressive intraocular tumor with a high propensity to metastasize. Accurate prognostication is relevant for patient counselling, planning of follow-up and stratification of patients in clinical trials. Discoveries of prognostically relevant genetic markers in the last few decades have fuelled the advancement of prognostication in UM considerably. In this thesis, we explored ways of improving genetic prognostication in UM, evaluated the effect of irradiation on chromosome testing, and investigated the association of DNA repair genes and epigenetic regulators with prognosis. We reveal that chromosome markers of high malignancy such as monosomy 3 and chromosome 8q gain are less often observed in patients who die due to metastases at a late stage. We demonstrate that combining the AJCC staging and chromosome 3 and 8q status results in enhanced risk stratification. We provide evidence that supports the taking of biopsies before radiotherapy is applied since chromosome testing seems to fail more often in irradiated tumors. Furthermore, we show that evaluating the role of DNA repair and epigenetics in uveal melanoma can help in unraveling the biology of uveal melanoma and identifying new markers for prognostication. Show less
The term primary cutaneous B-cell lymphomas refers to a heterogeneous group of B-cell non-Hodgkin lymphomas, that present in the skin without evidence of extracutaneous disease at the time of... Show moreThe term primary cutaneous B-cell lymphomas refers to a heterogeneous group of B-cell non-Hodgkin lymphomas, that present in the skin without evidence of extracutaneous disease at the time of diagnosis. In recent years, there has been considerable debate regarding the classification and terminology of the group of primary cutaneous B-cell lymphomas and different classification schemes were used. In the new WHO-EORTC consensus classification for cutaneous lymphomas published in 2005, three major groups of primary cutaneous B-cell lymphoma are distinguished: primary cutaneous marginal zone B-cell lymphoma and primary cutaneous follicle center lymphoma with a good prognosis, and primary cutaneous diffuse large B-cell lymphoma, leg type with an intermediate prognosis. Studies presented in this thesis focus on three aspects of these primary cutaneous B-cell lymphomas: (1) the clinical usefulness of the WHO-EORTC classification in daily practice, (2) the validity of prognostic parameters reported in previous studies and identified in patient groups classified according to previously used classification schemes and (3) optimal management for the different types of primary cutaneous B-cell lymphomas as defined in the WHO-EORTC classification. Show less