Abstract

In Reply. —If there were a reliable and practical direct method for measuring tumor volume, that method might well provide a prognostic indicator better than largest tumor diameter of posterior uveal melanomas. Unfortunately, there is no such method currently available. In our extensive clinical experience, choroidal and ciliary body melanomas commonly have very irregular shapes. Although the volume computation suggested by Dr O'Rourke would be quite appropriate for some of these tumors, it would be inappropriate for many others. Furthermore, we have (in our Cox modeling of potential risk factors) investigated numerous volume formulas, including the one Dr O'Rourke suggests, as well as more simple formulas such as the cubic volume computation commonly used. What we have found from those explorations is that largest tumor diameter still appears to be as good a predictor of mortality as any of the computed volumes based on maximal and minimal basal diameters and

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