Predicting the prognosis of ciliochoroidal uveal melanoma by its clinical characteristics: a European ophthalmic oncology group collaborative study

Abstract

Abstract Purpose: To assess clinical characteristics independently associated with mortality from uveal melanoma using a large contemporary European dataset in order to improve future classifications. Methods: Data of 8340 patients who had a choroidal and ciliary body melanoma managed by one of five participating ocular oncology centers directed by members of the European Ophthalmic Oncology Group (OOG) were collated. Variables requested included date of treatment and last follow‐up, survival status, largest basal tumour diameter (LBD), tumour thickness, ciliary body involvement and extraocular extension. Data were analysed with the product‐limit method and Cox regression. Results: Valid LBD and thickness was available for for 7922 and 8111 melanomas, and ciliary and extraocular extension for 7418 and 6087 tumours, respectively. Complete data for all 4 variables were available for 5469 tumours (66%). Mean follow‐up time was 4.0 years (interquartile range, 1.5‐7.3). In Cox regression, all variables were significantly (P<0.0001) and independently associated with melanoma‐related mortality. Covariate‐adjusted hazard ratio (HR) was 1.15 for LBD and 1.06 for thickness (each 1 mm increase), and 1.72 for ciliary body involvement and 2.29 for presence of extraocular extension (yes or no). Conclusions: Choroidal and ciliary body melanomas may effectively be categorised by LBD and thickness, and subcategorized by presence of ciliary body and extraocular extension. All four variables are recommended to be included in future clinical classifications of uveal melanoma. How ciliary body and extraocular extension could be collaboratively coded in more detail remains to be discussed.