[Survival after treatment for malignant choroidal melanoma: comparison between conservative therapy (Ru106/Rh106 applicator) and enucleation with and without postoperative irradiation to the orbit; 1960 to 1979].

The survival rate was calculated using the life table method in 1,501 patients suffering from choroidal melanomas and treated in 10 eye hospitals in the GDR between 1960 and 1979. The results of treatment by (1) enucleation, (2) enucleation with postoperative irradiation of the orbit and (3) local irradiation with 106Ru/106Rh were compared. The 10-year survival rate in patients treated by 106Ru/106Rh irradiation (n = 187) was 72%; in a group of patients similar with regard to age, tumor size and cell type, but who had undergone enucleation (n = 241) the 10-year survival rate was 49%. This clearly indicates that irradiation of small melanomas with 106Ru/106Rh applicators (tumor base not larger than 10 mm, tumor height not more than 2 mm) produces the best therapeutic results. There was no statistically proven difference between survival rates in patients treated with enucleation and enucleation combined with postoperative irradiation of the orbit. Postoperative irradiation of the orbit does not improve the survival rate. The 10-year survival rate in patients aged up to 49 years was 83% after 106Ru/106Rh and 81% after enucleation; it was not possible to prove a difference statistically. The 10-year survival rate in patients aged between 50 and 69 years was 80% after 106Ru/106Rh (n = 93) and 46% after enucleation (n = 146). The superiority of local beta irradiation was statistically proven. The expected survival of people aged 70 years and over was affected neither by the choroidal melanoma nor by different therapeutic procedures.