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Prognostic value of clinical and histopathological parameters in conjunctival melanomas: a retrospective study
Gerasimos Anastassiou1, Arnd Heiligenhaus, Nikos Bechrakis
1Department of Ophthalmology, University Hospital Essen, University of Essen, Germany. gerasimos.anastassion@uni-essen.de
Aim:
To determine prognostic factors for recurrence of disease and tumour related mortality in patients with conjunctival melanoma.
Methods:
A retrospective analysis of clinical and histopathological data of 69 patients with histologically verified conjunctival melanoma.
Results:
As univariate analysis showed, significant risk factors for the development of recurrence were: irregular pigmentation (RR = 2.0, p = 0.0007), incomplete surgical excision (RR = 3.5, p = 0.008), tumour invasion deeper than in substantia propria (RR = 3.9, p = 0.008), and presence of epithelioid tumour cells (RR = 2.9, p = 0.05). For tumour related mortality a significantly increased risk was found for tumour location in palpebral conjunctiva, caruncle, plica, or fornices (RR = 5.9, p = 0.001), for tumour infiltration deeper than the substantia propria (RR = 5.5, p = 0.001), for incomplete surgical excision (RR = 4.4, p = 0.05), and for nodular or mixed (nodular and superficial) growth pattern of the tumours (RR = 1.2, p = 0.002). The use of an adjuvant therapy for the surgical excision of the melanomas had no statistically significant influence upon the development of recurrent disease nor upon the tumour related mortality.
Conclusion:
These data present similar clinical and histopathological risk factors for patients with conjunctival melanoma as reported previously. The present study also addresses the failure of retrospective studies on conjunctival melanoma to prove the efficacy of a supplementary therapy to surgical excision.