Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, PA.
Asia Pac J Ophthalmol (Phila). 2020 Dec 9;10(2):146-151. doi: 10.1097/APO.0000000000000343.
The aim of this study was to evaluate outcomes of conjunctiva melanoma based on the American Joint Committee on Cancer Classification (AJCC) 8th edition.
Retrospective interventional case series.
Outcomes analysis of 425 patients.
In this analysis of 425 patients with conjunctival melanoma, there were 266 (63%) patients classified as T1, 75 (18%) as T2, 84 (20%) as T3, and 0 (0%) as T4. A comparison (T1 vs T2 vs T3) revealed that history of primary acquired melanosis was more common in T2 (81% vs 96% vs 81%; P = 0.01) and conjunctival nevus more common in T1 (20% vs 9% vs 11%; P = 0.03). Of 381 patients with follow-up (mean of 57.6 months), comparison revealed higher T category with increasing local recurrence/new tumor (30% vs 43% vs 49%; P = 0.004), increasing exenteration (3% vs 9% vs 28%; P < 0.001), increasing melanoma-related locoregional lymph node metastasis (2% vs 7% vs 12%; P = 0.001), increasing melanoma-related systemic metastasis (9% vs 25% vs 23%; P < 0.001), and increasing melanoma-related death (4% vs 12% vs 18%; P < 0.001). A comparison at 10 years revealed visual acuity loss of >3 lines (32% vs 42% vs 63%; P < 0.001), melanoma recurrence/new tumor (47% vs 70% vs 74%; P < 0.001), exenteration (4% vs 24% vs 46%; P < 0.001), melanoma-related locoregional lymph node metastasis (3% vs 13% vs 25%; P < 0.001), melanoma-related systemic metastasis (13% vs 45% vs 40%; P < 0.001), and melanoma-related death (8% vs 22% vs 37%; P < 0.001).
Based on the AJCC 8th edition of conjunctival melanoma, the 10-year risk per T category significantly increased for visual acuity loss of >3 lines, recurrence/new tumor, exenteration, locoregional and systemic melanoma-related metastasis, and melanoma-related death.
本研究旨在评估基于美国癌症联合委员会第 8 版（AJCC）的结膜黑色素瘤的结局。
回顾性干预性病例系列。
对 425 例患者进行结局分析。
在这项对 425 例结膜黑色素瘤患者的分析中，266 例（63%）患者被归类为 T1，75 例（18%）为 T2，84 例（20%）为 T3，0 例（0%）为 T4。T1 与 T2 和 T3 之间的比较显示，原发性获得性黑色素沉着史在 T2 中更为常见（81%比 96%比 81%；P=0.01），而在 T1 中更为常见的是结膜痣（20%比 9%比 11%；P=0.03）。在 381 例有随访（平均随访时间为 57.6 个月）的患者中，比较显示随着 T 分期的增加，局部复发/新发肿瘤（30%比 43%比 49%；P=0.004）、眼窝内容剜除术（3%比 9%比 28%；P<0.001）、黑色素瘤相关局部区域淋巴结转移（2%比 7%比 12%；P=0.001）、黑色素瘤相关全身转移（9%比 25%比 23%；P<0.001）和黑色素瘤相关死亡（4%比 12%比 18%；P<0.001）也随之增加。在 10 年的比较中，视力丧失>3 行（32%比 42%比 63%；P<0.001）、黑色素瘤复发/新发肿瘤（47%比 70%比 74%；P<0.001）、眼窝内容剜除术（4%比 24%比 46%；P<0.001）、黑色素瘤相关局部区域淋巴结转移（3%比 13%比 25%；P<0.001）、黑色素瘤相关全身转移（13%比 45%比 40%；P<0.001）和黑色素瘤相关死亡（8%比 22%比 37%；P<0.001）的风险也显著增加。
基于 AJCC 第 8 版，每 T 分期 10 年的风险显著增加，与视力丧失>3 行、复发/新发肿瘤、眼窝内容剜除术、局部和全身黑色素瘤相关转移以及黑色素瘤相关死亡有关。
