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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Conjunctival melanoma treatment outcomes in 288 patients: a multicentre international data-sharing study

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  • Puneet Jain
  • Paul T Finger
  • Maria Fili
  • Bertil Damato
  • Sarah E Coupland
  • Heinrich Heimann
  • Nihal Kenawy
  • Niels J Brouwer
  • Marina Marinkovic
  • Sjoerd G Van Duinen
  • Jean Pierre Caujolle
  • Celia Maschi
  • Stefan Seregard
  • David Pelayes
  • Martin Folgar
  • Yacoub A Yousef
  • Hatem Krema
  • Brenda Gallie
  • Alberto Calle-Vasquez
  • American Joint Committee on Cancer Ophthalmic Oncology Task Force
  • Steffen Heegaard (Member of study group)
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BACKGROUND: To relate conjunctival melanoma characteristics to local control.

METHODS: Retrospective, 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.

RESULTS: 288 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.

CONCLUSION: This 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.

Original languageEnglish
JournalThe British journal of ophthalmology
Volume105
Issue number10
Pages (from-to)1358-1364
Number of pages7
ISSN0007-1161
DOIs
Publication statusPublished - Oct 2021

ID: 61988194