A committee was formed to create patient-specific data fields for patients with
uveal melanoma. Ten subspecialty ophthalmic oncology centers from 4 continents shared data. Patient selection criteria included diagnosis of
uveal melanoma from April 1, 2001, to April 1, 2011, adequate records to allow
tumor staging by the AJCC criteria, and follow-up for metastatic
melanoma.
INTERVENTIONS: A total of 3809 patients were entered into the database. Of these, 3377 records (88.7%) were complete. Primary ciliary body and choroidal
melanoma was the diagnosis for 3217, and 160 had primary iris
melanoma.
Tumor size categories were T1 in 1115 (34.7%) of the 3217 patients, T2 in 1128 patients (35.1%), T3 in 789 patients (24.5%), and T4 in 185 patients (5.8%). The 5- and 10-year Kaplan-Meier
metastasis-free point estimates by
tumor size categories were 97% (95% CI, 95%-98%) and 94% (95% CI, 91%-96%) for T1
tumors, 85% (95% CI, 82%-88%) and 80% (95% CI, 75%-84%) for T2
tumors, 77% (95% CI, 73%-80%) and 68% (95% CI, 60%-74%) for T3
tumors, and 61% (95% CI, 49%-71%) (5-year only) for T4
tumors, respectively. Increasing
tumor size was consistent with increased
metastasis risk (P < .001). Subclassifications were significantly associated with increased risk of
metastasis (P < .001). The AJCC prognostic and anatomical groupings were as follows: stage I, 1030 (32.0%); stage IIA, 1095 (34.0%); stage IIB, 710 (22.1%); stage IIIA, 282 (8.8%); stage IIIB, 79 (2.5%); and stage IIIC, 21 (0.7%). The 5- and 10-year Kaplan-Meier
metastasis-free estimates for prognostic stages were 97% (95% CI, 95%-98%) and 94% (95% CI, 91%-96%) for stage I, 89% (95% CI, 86%-91%) and 84% (95% CI, 80%-88%) for stage IIA, 79% (95% CI, 75%-83%) and 70% (95% CI, 62%-76%) for stage IIB, 67% (95% CI, 59%-73%) and 60% (95% CI, 51%-68%) for stage IIIA, 50% (95% CI, 33%-65%) and 50% (95% CI, 33%-65%) for stage IIIB, and 25% (95%
CI, 4%-53%) (5-year only) for stage IIIC, respectively. The 160 iris
melanomas were too few for subgroup analysis.
CONCLUSIONS AND RELEVANCE: