THE SMALL FATAL CHOROIDAL MELANOMA STUDY A Survey by the European Ophthalmic Oncology Group

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Jouhi , S , Jager , M J , de Geus , S J R , Desjardins , L , Eide , N A , Grange , J-D , Kiilgaard , J F , Seregard , S , Midena , E , Parrozzani , R , Caujolle , J-P , Rospond-Kubiak , I & Kivelä , T T 2019 , ' THE SMALL FATAL CHOROIDAL MELANOMA STUDY A Survey by the European Ophthalmic Oncology Group ' , American Journal of Ophthalmology , vol. 202 , pp. 100-108 .

Title: THE SMALL FATAL CHOROIDAL MELANOMA STUDY A Survey by the European Ophthalmic Oncology Group
Author: Jouhi, Susanna; Jager, Martine J.; de Geus, Stefan J.R.; Desjardins, Laurence; Eide, Nils Andreas; Grange, Jean-Daniel; Kiilgaard, Jens Folke; Seregard, Stefan; Midena, Edoardo; Parrozzani, Raffaele; Caujolle, Jean-Pierre; Rospond-Kubiak, Iwona; Kivelä, Tero T.
Contributor organization: Silmäklinikka
HUS Head and Neck Center
Department of Ophthalmology and Otorhinolaryngology
University of Helsinki
Date: 2019-06
Language: eng
Number of pages: 9
Belongs to series: American Journal of Ophthalmology
ISSN: 0002-9394
Abstract: PURPOSE: To determine the size at which choroidal melanomas can metastasize and to report the characteristics of small fatal choroidal melanomas (SFCM). DESIGN: Retrospective case series. METHODS: Ten ocular oncology services submitted 45 patients with a choroidal melanoma 3 mm or less in thickness and 9 mm or less in largest basal diameter (LBD), when treated, who developed metastases. RESULTS: Median tumor thickness was 2.4 mm (range, 1.0-3.0 mm) and LBD 7.3 mm (range, 3.0-9.0 mm). Of 14 (31%) tumors that were first observed, 12 grew a median of 0.5 mm (range, 0.1-1.2 mm) in thickness and 1.0 mm (range, 0-3.0 mm) in LBD within a median of 7 months; 3 were initially smaller than 3 mm in LBD. Number of risk factors for growth and metastasis was 0 for 4% of the tumors; 60% were over 2 mm in thickness, 63% had subretinal fluid, 84% caused symptoms, 57% had orange pigment, and 92% were within 3 mm of the disc. Local recurrence occurred in 8 of 31 eyes (26%) treated conservatively. Median metastasis-free survival was 4.5 years (range, 0.8-15.7 years). Kaplan-Meier estimate of metastasis developing was 15% (95% confidence interval [CI], 7-26), 51% (95% CI, 36-64) and 85% (95% CI, 71-92) by 2, 5, and 10 years, respectively. By the time of analysis, 37 patients had died of metastasis after a median of 7 months. CONCLUSIONS: Choroidal melanomas less than 3.0 mm in LBD are highly unlikely to metastasize. Risk factors of an SFCM are similar to those for all choroidal melanomas of similar size. (C) 2019 The Author(s). Published by Elsevier Inc.
3125 Otorhinolaryngology, ophthalmology
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: acceptedVersion

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