Multicenter, International Assessment of the Eighth Edition of the American Joint Committee on Cancer <i>Cancer Staging Manual</i> for Conjunctival Melanoma

Jain, Puneet; Finger, Paul T.; Damato, Bertil; Coupland, Sarah E.; Heimann, Heinrich; Kenawy, Nihal; Nj, Brouwer; Marinković, Marina; Sg, van Duinen; Caujolle, Jp; Maschi, C.; Seregard, Stefan; Pelayes, David E.; M, Folgar; Yousef, Yacoub A.; Krema, Hatem; Gallie, Brenda L.; A, Calle-Vasquez

doi:10.1001/jamaophthalmol.2019.1640

Cited by 39 publications

(49 citation statements)

References 20 publications

(63 reference statements)

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“…In search of a prognostic tool that provides information on the aggressiveness of CM in relation to local recurrence or systemic metastases, this study identified a prognostic transcriptional signature comprised of twenty genes allowing a classification of the clinical outcome of CM with high accuracy. The clinical and histopathological standard predictors, such as TNM stage, tumor thickness and tumor localization 6 were not significantly associated with the clinical outcome in our study, although some tendency was observed which may be explained by the low sample size of our study. These results underline the potential of a transcriptional analysis to categorize clinical outcome.…”

Section: Discussioncontrasting

confidence: 74%

Transcriptional characterization of conjunctival melanoma identifies the cellular tumor microenvironment and prognostic gene signatures

Wolf¹,

Auw-Haedrich²,

Schlecht³

et al. 2020

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This study characterizes the transcriptome and the cellular tumor microenvironment (TME) of conjunctival melanoma (CM) and identifies prognostically relevant biomarkers. 12 formalin-fixed and paraffin-embedded CM were analyzed by MACE RNA sequencing, including six cases each with good or poor clinical outcome, the latter being defined by local recurrence and/or systemic metastases. Eight healthy conjunctival specimens served as controls. The TME of CM, as determined by bioinformatic cell type enrichment analysis, was characterized by the enrichment of melanocytes, pericytes and especially various immune cell types, such as plasmacytoid dendritic cells, natural killer T cells, B cells and mast cells. Differentially expressed genes between CM and control were mainly involved in inhibition of apoptosis, proteolysis and response to growth factors. POU3F3, BIRC5 and 7 were among the top expressed genes associated with inhibition of apoptosis. 20 genes, among them CENPK, INHA, USP33, CASP3, SNORA73B, AAR2, SNRNP48 and GPN1, were identified as prognostically relevant factors reaching high classification accuracy (area under the curve: 1.0). The present study provides new insights into the TME and the transcriptional profile of CM and additionally identifies new prognostic biomarkers. These results add new diagnostic tools and may lead to new options of targeted therapy for CM.

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Section: Discussioncontrasting

confidence: 74%

Transcriptional characterization of conjunctival melanoma identifies the cellular tumor microenvironment and prognostic gene signatures

Wolf¹,

Auw-Haedrich²,

Schlecht³

et al. 2020

Sci Rep

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“…This database has been used to validate/assess the eighth edition of the AJCC staging manual for conjunctival melanoma. 5…”

Section: Introductionmentioning

confidence: 99%

Conjunctival melanoma treatment outcomes in 288 patients: a multicentre international data-sharing study

et al. 2020

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BackgroundTo relate conjunctival melanoma characteristics to local control.MethodsRetrospective, registry-based interventional study with data gathered from 10 ophthalmic oncology centres from 9 countries on 4 continents. Conjunctival melanoma patients diagnosed between January 2001 and December 2013 were enrolled in the study. Primary treatments included local excision, excision with cryotherapy and exenteration. Adjuvant treatments included topical chemotherapy, brachytherapy, proton and external beam radiotherapy (EBRT). Cumulative 5-year and 10-year Kaplan-Meier local recurrence rates were related to clinical and pathological T-categories of the eighth edition of the American Joint Committee on Cancer (AJCC) staging system.Results288 patients had a mean initial age of 59.7±16.8 years. Clinical T-categories (cT) were cT1 (n=218,75.7%), cT2 (n=34, 11.8%), cT3 (n=15, 5.2%), cTx (n=21,7.3%) with no cT4. Primary treatment included local excision (n=161/288, 55.9%) followed by excision biopsy with cryotherapy (n=108/288, 37.5%) and exenteration (n=5/288, 1.7%). Adjuvant therapies included topical mitomycin (n=107/288, 37.1%), plaque-brachytherapy (n=55/288, 19.1%), proton-beam (n=36/288, 13.5%), topical interferon (n=20/288, 6.9%) and EBRT (n=15/288, 5.2%). Secondary exenteration was performed (n=11/283, 3.9%). Local recurrence was noted in 19.1% (median=3.6 years). Cumulative local recurrence was 5.4% (3.2–8.9%), 19.3% (14.4–25.5%) and 36.9% (26.5–49.9%) at 1, 5 and 10 years, respectively. cT3 and cT2 tumors were twice as likely to recur than cT1 tumours, but only cT3 had statistically significantly greater risk of local recurrence than T1 (p=0.013). Factors such as tumour ulceration, plica or caruncle involvement and tumour thickness were not significantly associated with an increased risk of local recurrence.ConclusionThis multicentre international study showed that eighth edition of AJCC tumour staging was related to the risk of local recurrence of conjunctival melanoma after treatment. The 10-year cumulative local recurrence remains high despite current management.

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“…A CM stádiumbeosztása a TNM-rendszer szerint történik [2]. A T betű a primer tumor méretére és kiterjedésére, az N betű a regionális nyirokcsomó érintettségére, az M betű a távoli áttétre vonatkozó információkat jelöli.…”

Section: Stádiumbeosztásunclassified

“…Az American Joint Committee on Cancer által kiadott legújabb, 2019-es Cancer Staging Manual for CM [2] szerint a CM-ben az áttétképződés valószínűsége 4,3 évvel (medián) a diagnózist követően 8,5%, mortalitása pedig 5,3 évvel (medián) a diagnózis megléte után 10,1%. A kumulatív mortalitási ráta cT1-es stádium esetén 5 évnél 2,5% és 10 év után 15,2%, cT2-es stádiumban 5 évnél 28,6% és 10 év után 43,6%, illetve cT3-as stádiumban 5 évnél 31,6% a diagnózist követően.…”

Section: Stádiumbeosztásunclassified

“…A CM igen ritka, a szemgolyó elvesztésének kockázatával járó és az életet veszélyeztető kórkép, melynek mortalitása 5 év alatt a 30%-ot, 10 év alatt pedig a 43%ot is elérheti [2]. A szemfelszíni laphám-neoplasiát (OSSN) követően a második leggyakrabban előforduló szemfelszíni malignoma, továbbá az uvealis melanoma malignum és az OSSN után a harmadik leggyakoribb ocularis rosszindulatú daganat [3].…”

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Pigmentsejt-eredetű szemfelszíni elváltozások differenciáldiagnózisa és kezelése

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Absztrakt: Célunk a pigmentsejt-eredetű szemfelszíni elváltozások (conjunctivalis naevus, primer szerzett melanosis és conjunctivalis melanoma) összefoglaló ismertetése, különös hangsúlyt fektetve a klinikai megjelenésre, differenciáldiagnosztikára és kezelésre. A naevus a leggyakoribb benignus, pigmentsejt-eredetű conjunctivatumor. A primer szerzett (akvirált) melanosis közép- vagy időskorúakban jelenik meg, a conjunctivalis hám melanocytáinak proliferációja következtében. A conjunctivalis melanoma ritka daganat, a szemfelszíni laphám-neoplasia után a második leggyakoribb szemfelszíni malignus tumor, illetve a chorioidealis melanoma malignumot és a szemfelszíni laphám-neoplasiát követően a harmadik leggyakoribb ocularis malignoma. Rendkívül magas malignitási és áttétképzési potenciálja miatt fontos a korai felismerése és a megfelelő módon való kezelése. A gyakori recidívaképződés miatt kezelésében elengedhetetlen az intra- és posztoperatív adjuváns kezelési módok ismerete és alkalmazása, valamint a rendszeres kontrollvizsgálat. Orv Hetil. 2020; 161(15): 563–574.

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Multicenter, International Assessment of the Eighth Edition of the American Joint Committee on Cancer Cancer Staging Manual for Conjunctival Melanoma

Abstract: This case series assesses whether the eighth edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual can be used to accurately estimate mortality rates of conjunctival melanoma.

Cited by 39 publications

References 20 publications

Transcriptional characterization of conjunctival melanoma identifies the cellular tumor microenvironment and prognostic gene signatures

Transcriptional characterization of conjunctival melanoma identifies the cellular tumor microenvironment and prognostic gene signatures

Conjunctival melanoma treatment outcomes in 288 patients: a multicentre international data-sharing study

Pigmentsejt-eredetű szemfelszíni elváltozások differenciáldiagnózisa és kezelése

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