Conjunctival melanoma: outcomes based on tumor origin in 382 consecutive cases

Ophthalmology. 2011 Feb;118(2):389-95.e1-2. doi: 10.1016/j.ophtha.2010.06.021. Epub 2010 Aug 17.

Abstract

Purpose: To evaluate prognostic factors based on origin of conjunctival melanoma.

Design: Interventional case series.

Participants: Three hundred eighty-two consecutive patients.

Methods: Retrospective chart review.

Main outcome measures: Melanoma-related metastasis and death.

Results: The melanoma arose from primary acquired melanosis (PAM; n = 284; 74%), from pre-existing nevus (n = 26; 7%), and de novo (n = 72; 19%). The mean tumor base was 11 mm for melanoma arising from PAM, 6 mm for melanoma arising from nevus, and 10 mm for those arising de novo. At 5 years (10 years), melanoma metastasis occurred in 19% (25%) in melanoma arising from PAM (P = 0.003), 10% (26%) in melanoma from nevus (P = 0.193), and 35% (49%) in those de novo. Factors predictive of metastasis by multivariable analysis included tumor origin de novo (P = 0.001), palpebral location (P<0.001), nodular tumor (P = 0.005), and orbital invasion (P = 0.022). At 5 years (10 years), melanoma-related death occurred in 5% (9%) in melanoma arising from PAM (P<0.001), 0% (9%) in melanoma arising from nevus (P<0.057), and 17% (35%) in those arising de novo. Factors predictive of death by multivariable analysis included tumor origin de novo (P<0.001), fornix location (P = 0.04), and nodular tumor (P = 0.001).

Conclusions: Melanoma arising de novo carries a higher risk of melanoma-related metastasis and death compared with those cases arising from PAM or nevus.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Conjunctival Neoplasms / mortality
  • Conjunctival Neoplasms / pathology*
  • Female
  • Humans
  • Male
  • Melanoma / mortality
  • Melanoma / pathology*
  • Melanosis / pathology
  • Middle Aged
  • Nevus / pathology
  • Prognosis
  • Retrospective Studies
  • Survival Rate