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Small fatal choroidal melanomas: A survey by the European Ophthalmic Oncology Group
Author(s) -
Jouhi S.,
Jager M.,
Desjardins L.,
Eide N.,
RospondKubiak I.,
Caujolle J.P.,
Grange J.D.,
Kiilgaard J.F.,
Scheen L.,
Midena E.,
Raffaele P.,
Kivelä T.
Publication year - 2017
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.1755-3768.2017.03641
Subject(s) - medicine , melanoma , incidence (geometry) , choroidal melanoma , ciliary body , ophthalmology , surgery , physics , cancer research , optics
Purpose To assess retrospectively characteristics of smallest choroidal melanomas that metastasized. Methods Ten ocular oncology services submitted data anonymously through a secure website. Eligible were patients with a choroidal or ciliary body melanoma <3 mm in thickness and <9 mm in diameter that developed metastases. Of 57 patients submitted, 49 fulfilled all eligibility criteria. Results At treatment, median age was 57 years (range, 26–81), tumor thickness 2.3 mm (range, 0.4–3.0) and diameter 7.2 mm (range, 3.0–9.0). Fifteen tumors (31%) were observed before treatment, and 13 of them grew a median of 0.5 mm (range, 0.1–1.2) in thickness and 1.0 mm (range, 0–3.0) in diameter in a median of 7 months (range, 2.5 months–5.8 years). Fifty‐seven percent were >2 mm in thickness, 62% had subretinal fluid, 77% caused symptoms, 51% had orange pigment, and 79% a margin within 3 mm of the optic disk (25%) touched disk margin). The number of high risk characteristics was 0 for 10% of the tumours and ranged 1–5 for 12%, 29%, 31%, 14%, and 4%. Local recurrence developed in 18% of eyes. By study design, all developed metastatic melanoma. Cumulative incidence estimate for metastasis developing was 14% (95% CI, 6–25) by 2 years, 51% (95% CI, 36–64) by 5 years, and 86% (95% CI, 72–93) by 10 years after treatment. Median relapse‐free survival was 4.5 years. Conclusions Ten percent of the smallest choroidal melanomas that metastasized had no high risk characteristic for growth. One third was followed for growth, which may or may not have influenced outcome. We found only 5 melanomas in 10 centres that were <4.5 mm (3 DD) in diameter and none that was <3 mm and metastasized.