Clinical predictive factors for development of recurrence and metastasis in conjunctival melanoma: a review of 68 cases.

Abstract

ResultsThere were 68 patients with conjunctival melanoma who were evaluated and treated: all were white. Of the 68 conjunctival melanomas, 37 (54%) involved the right eye, 31 (46%) the left eye, and none were bilateral. The tumour either appeared as a new conjunctival lesion or a change (increase in pigmentation or size) in a previously static conjunctival lesion as noted by the patient or the ophthalmologist. The mean follow up was 7-5 years (range 0F4-28-3 years; median, 6-8 years).Among the 68 patients with conjunctival melanoma there were 43 patients (65%) who were treated initially at another institution and referred to us for evaluation and further treatment because of the histopathological diagnosis of conjunctival melanoma. Twenty five patients (35%) were evaluated and treated initially at our institution by us using our standard techniques. 16 To ensure that there was no bias in our analysis, we elected to evaluate this subgroup of 25 patients separately in order to determine the clinical parameters that were significantly associated with local recurrence and metastasis and compare this with the total group of 68 patients.The presumed origin of the conjunctival 624 on 11 May 2018 by guest. Protected by copyright.

Conjunctival melanoma and melanocytic intra-epithelial neoplasia

“…23,38,39 Risk factors for recurrence are reported to be: multifocal disease, non-limbal position of the tumour, involvement of the surgical margin, and surgical excision without adjunctive treatment. 27,40 Our rates of recurrence are only 1.5% at a median of 2.2 years for patients treated primarily at our centre and 1.9% at a median 1.6 years (range 0-6.98) for salvage therapy for patients who initially had surgery elsewhere. This is likely to be because we routinely administer adjunctive radiotherapy irrespective of histological clearance.…”

“…44 Systemic disease most commonly involves lungs, brain, liver, skin, bones, and gastrointestinal tract, and is typically detected at a median of 3.4 years. 40 The estimated 5-years mortality of CoM is 12-19%, whereas the 10-years mortality rate is B30%. 1,23,25,27,42 Genetic abnormalities of CoM CoMs show mutation of BRAF (7q34).…”

Conjunctival melanoma: survival analysis in twenty-two Mexican patients

“…Patients treated initially with tumor excision alone had a statistically higher recurrence rate than those treated initially with excision and supplemental cryotherapy (12,13) . Surgical treatment of conjunctival melanoma has evolved to more conservative procedures.…”

Evaluation of Treatment Results According to Clinical AJCC Staging in Conjunctival Malignant Melanoma

“…Kaplan Meier 19 Buna rağmen, son dönem çalışmalarda da yüksek nüks oranları görülmeye devam etmektedir. Nüks ile ilişkili olduğu gösterilen faktörler arasında; tümörün limbustan uzakta yerleşimi, karünkül tutulumu, tümörün primer akkiz melanozis kaynaklı olması, yaygın/büyük tümör, multifokal yerleşim, tümörün evre T2 ve T3 olması, cerrahi sınırda tümör mevcudiyeti ve adjuvan tedavi uygulanmaması bulunmaktadır.…”

“…[16][17][18] Çeşitli çalışmalarda cerrahi teknik, cerrahi sınırda tümör mevcudiyeti ve adjuvan tedavi kullanılmaması tümör nüksü ile tümörün boyutu ve yerleşimi ise nüks ve metastaz ile ilişki-lendirilmiştir. 16,[19][20][21][22] Konj MM'nin klinik evrelemesinde güncel olarak 2017 yılı başında yayımlanan Amerika Kanser Ortak Komitesi [American Joint Commitee on Cancer (AJCC)] sekizinci edisyonu kullanılmaktadır (Tablo 1). 23 Bu sistemde tümör boyutları ve yerleşimi birlikte değerlendirilerek evrelendirme yapıl-maktadır, bu nedenle AJCC evresinin nüks ve metastaz riskini belirlemede faydalı bir prognostik faktör olduğunu gösteren yayınlar mevcuttur.…”