Conjunctival Melanoma in Asian Indians: A Study of 42 Patients

Kaliki, Swathi; Vasanthapuram, Varshitha Hemanth; Mishra, Dilip Kumar

doi:10.1080/08820538.2019.1620793

Cited by 9 publications

(9 citation statements)

References 24 publications

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“…This is similar to previous studies on UM in Chinese and Koreans which reported an earlier age of presentation for UM (mean age 48 to 53 years) 11,13 compared to Caucasians (mean age 60 years) 9 . For CM, Chinese and Indian patients also have a younger age at presentation (mean age 43 to 54 years) 15,17 compared to Caucasians (mean age 55 to 65 years) 6 . Survival analysis in our study was focused on patients with non-metastatic disease as tumour behaviour and prognostic factors of primary non-metastatic and metastatic disease differ greatly 20 .…”

Section: Discussionmentioning

confidence: 99%

“…In our cohort, the 5-year RFS and OS for CM (n = 14) are 30.1% and 68.8%, respectively. Studies in China (n = 57) 15 and India (n = 42) 17 report 5-year tumour-related death rates at 30.5% and 11% respectively. CM outcomes in Caucasian populations vary with 5-year cancer-specific survival ranging from 93% in the US 25 to 86.3% in the Netherlands (n = 194) 26 .…”

Section: Discussionmentioning

confidence: 99%

“…www.nature.com/scientificreports/ slightly higher 5-year cancer-specific survival ranging from 70 to 80%. On the contrary for CM, poorer survival outcomes have been reported in Asians compared to Caucasians, due in part to the advanced stages at presentation and poor melanoma awareness in Asia 15,17 . In our cohort, the 5-year RFS and OS for CM (n = 14) are 30.1% and 68.8%, respectively.…”

Section: Disease Characteristics and Histopathological Features In Tmentioning

confidence: 99%

“…Asian reports on UM include those from China 11,12 and South Korea 13,14 , while those on CM include those from China 15,16 and India 17 . Compared to Western cohorts, Asian patients presented at an earlier age for both UM and CM 11,17 . The prognosis of Asian patients however, vary across studies and remains to be better defined 11,14,15 .…”

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confidence: 99%

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Clinical features and survival outcomes of ocular melanoma in a multi-ethnic Asian cohort

Tan

Hong

Goh

et al. 2020

Sci Rep

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Ocular melanomas are uncommon cancers in Southeast Asia unlike in the West. We conducted a retrospective review of patients (n = 44) with histologically-proven ocular melanoma within a multi-ethnic Asian cohort from Singapore. Clinicopathological features and relapse patterns were examined, and survival outcomes of interest included recurrence-free survival (RFS) and overall survival (OS). Survival analysis was performed using the Kaplan–Meier method and multivariable Cox proportional regression. The study cohort included 18 male and 26 female patients, with a median age of 52 years (range 8–78). Median follow-up was 154 months. For uveal melanomas (n = 29), the 5-year RFS and OS was 56.8% and 76.6%, respectively; whilst for conjunctival melanomas (n = 15), the 5-year RFS and OS was 30.1% and 68.8%, respectively. Fifteen patients (38.5%) eventually developed metastasis, following which the median survival was only 17 months. Multivariate analysis demonstrated that higher T stage was a significant independent predictor for both OS (HR 8.69, 95% CI 1.03 to 73.09, p = 0.047) and RFS (HR 11.62, 95% CI 2.45 to 55.00, p = 0.002). Smoking history was independently predictive of better RFS (HR 0.08, 95% CI 0.01 to 0.78, p = 0.030). In conclusion, our study demonstrates the poor ocular melanoma outcomes in Southeast Asians, highlighting the necessity for urgent research in this area of unmet clinical need.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Disease Characteristics and Histopathological Features In Tmentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical features and survival outcomes of ocular melanoma in a multi-ethnic Asian cohort

Tan

Hong

Goh

et al. 2020

Sci Rep

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“…The incidence of Blacks was 0.18, and the incidence of Whites is 2.6 times higher than that of Blacks ( 28 ). Increased awareness of CM all around the world leads to the rising publications from outside Europe and North America, such as China ( 7 , 16 , 29 ), India ( 30 ), Japan ( 31 ) and South Korea ( 32 ). However, epidemiological information based on registration data from Asian and African countries is still needed to explore ethnic differences, which is currently only available for South Korea.…”

Section: Discussionmentioning

confidence: 99%

Publication trends of research on conjunctival melanoma during 1997–2022: A 25-year bibliometric study

Wang

Yang²,

Ge³

et al. 2022

Front. Oncol.

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BackgroundConjunctival melanoma (CM) is a life-threatening ocular tumor with a high rate of local recurrence and metastasis. Our objective is to analyze research trends in CM field and compare contributions from different countries, institutions and authors.MethodsWe extracted all CM-related publications published from 1997 to 2022 from the Web of Science database and applied Microsoft Excel and VOSviewer to review publication data, analyze publication trends, and visualize relevant data.ResultsA total of 708 publications were identified. The United States contributed the most publications (280) and citations (8,781 times) with the highest H-index value (47). The Ophthalmic Plastic and Reconstructive Surgery, British Journal of Ophthalmology, American Journal of Ophthalmology and Cornea were the most productive journal concerning CM, and Shields CL, Shields JA, Jager MJ as well as Finger PT had published the most papers in the field. Keywords were classified into three clusters: clinical research, management-related research and genetic research. The keywords “primary acquired melanosis”, “metastasis” and “BRAF mutations” were most frequently emerged. According to the average appearing year (AAY), targeted therapy (AAY of 2019.0) and nivolumab (AAY of 2018.7) were identified as the main focuses of the field in the near future.ConclusionIn the past 25 years, the United States, Germany, England and the Netherlands held the leading position in the CM research. A group of scholars made important contributions to CM research and will continue to guide cutting-edge research. Treatments that have been shown to be effective for advanced cutaneous melanoma, such as targeted therapy and immunotherapy, are potential focuses for future CM research.

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Factors affecting recurrence and metastasis in conjunctival melanoma

Çalış Karanfil,

Gündüz,

Gündüz

et al. 2023

Int Ophthalmol

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Purpose: To evaluate clinical and demographic characteristics and factors affecting recurrence, metastasis and survival in conjunctival melanoma (CM).Methods: The clinical records of 45 patients who were treated for CM between October 1998 and June 2022 were retrospectively evaluated. Age, gender, presence of underlying conjunctival nevus-primary acquired melanosis (PAM),tumor stage according to the 8th edition of the American Joint Committee on Cancer (AJCC) staging system, tumor basal diameter, tumor thickness, lymph node involvement, metastasis, presence of tumor at the surgical margin, treatment method, need for adjuvant therapy, local tumor control, recurrence, and survival were recorded.Results: Twenty-one (46.7%) patients were female and 24 (53.3%) patients were male. The mean age at diagnosis was 53.2 ±16.1 years. Fifteen (33.3%) patients had conjunctival PAM; 2 (4.4%) patients had conjunctival nevus. The tumor stage was T1 in 24 (53.0%), T2 in 13 (29.0%), and T3 in 6 (13.0%) of the cases. For stage T1 and T2 CM, in addition to excisional biopsy (EB)and cryotherapy, alcohol epitheliectomy (AE) was performed in 17 cases (37.8%), super cial sclerectomy (SS) was performed in 7 (15.6%), and amnion membrane transplantation (AMT) due to a large conjunctival defect in 9 (20.0%). Six (14.0%) T3 cases underwent primary exenteration. Positive surgical margins were observed in 23 (51.0%) of the excised tumors at histopathologic examination. Adjuvant topical mitomycin-C(MMC) was used in 7 (38.9%) and strontium-90 episcleral brachytherapy in 6 (33.3%) of the 23 cases with tumorpositive borders. During the follow-up, recurrence was seen in 14 (31.3%) cases. According to Kaplan Meier analysis, the mean time to recurrence development was 106.3±17.3 months and the 5-year survival rate was 52.0%. Fourteen of the recurrent cases underwent EB+ cryotherapy, 3 underwent AE+SS, and 3 underwent secondary exenteration. Metastasis and lymph node involvement occurred in 11 (25.0%) and 8 (18.2%) of the cases, respectively. Four (8.9%) cases expired. According to Kaplan-Meier analysis, the mean time to metastasis was 119.6±24.1 months and the 5-year survival rate was 52.0%. While recurrence was more frequent in melanomas developing from PAM/nevus, metastasis was more frequent in men and those with lymph node involvement.Conclusion: Conjunctival melanoma is a malignant tumor with high recurrence and metastasis rates.Precursor nevus/PAM is a risk factor for recurrence, while male gender and regional LN involvement are risk factors for metastasis.

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Conjunctival Melanoma in Asian Indians: A Study of 42 Patients

Cited by 9 publications

References 24 publications

Clinical features and survival outcomes of ocular melanoma in a multi-ethnic Asian cohort

Clinical features and survival outcomes of ocular melanoma in a multi-ethnic Asian cohort

Publication trends of research on conjunctival melanoma during 1997–2022: A 25-year bibliometric study

Factors affecting recurrence and metastasis in conjunctival melanoma

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