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The 7th edition of TNM predicts survival of patients with ciliochoroidal melanoma
Author(s) -
KUJALA E,
DAMATO BE,
COUPLAND SE,
DESJARDINS L,
BECHRAKIS NE,
GRANGE JD,
HARBOUR W,
KIVELÄ T
Publication year - 2010
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2010.3264.x
Subject(s) - medicine , stage (stratigraphy) , log rank test , survival analysis , basal (medicine) , melanoma , overall survival , gastroenterology , surgery , cancer research , biology , paleontology , insulin
Purpose To document that staging ciliochoroidal melanoma by the Tumor, Node, Metastasis (TNM 7th edition) system is reproducible between centres. Methods Data of 8252 patients (Berlin 689, Helsinki 270, Liverpool 3305, Lyon 473, Paris 3515) regarding tumour thickness, largest basal diameter, ciliary body and extrascleral extension were staged centre by centre. Stage‐specific survival was compared between centres using Kaplan‐Meier analysis and log rank test. Results Of these tumours, 21% (13‐25%) classified to stage I, 31% (28‐34%) to stage IIA , 23% (19‐32%) to stage IIB, 17% (16‐19%) to stage IIIA, 7% (5‐11%) to stage IIIB and 1% (0‐4%) to stage IIIC, respectively. The survival of patients treated in the five European ocular oncology centers differed significantly overall, probably because of differences in case mix and follow‐up. The survival did not differ significantly between centers in stage groups other than IA (P<0.014 and compared to P<0.013 in stage IIA, P<0.001 in IIB, P<0.001 in IIIA; P<0.001 in IIIB and P<0.003 in IIIC). The corresponding 5‐year survival rates for stages I, IIA‐B and IIIA‐C were 96% (87‐99% in 4 different centers), 89% (74‐93%), 82% (73‐85%), 67% (60‐81%), 46% (33‐61%) and 26% (12‐31%) by 5 years; and 88% (74‐89%), 80% (68‐82%), 68% (60‐65%), 45% (37‐53%), 28% (17‐33%) and 10% (7‐12%) by 10 years, respectively. In the fifth centre, the 5‐ and 10‐year survival rates were 82% and 74% even for Stage IIIB. Conclusion The first evidence‐based TNM classification of malignant ciliochoroidal melanoma equally predicts survival of patients in four of five different European ocular oncology centers regardless of their different case mix and preferred follow‐up and treatment practices.