An Australian choroidal melanoma survey. Factors affecting survival following enucleation

This study is based on a computer-assisted analysis 484 enucleated malignant melanomas of the choroid from The Royal Victorian Eye & Ear Hospital, Melbourne. The following factors which might influence survival were analysed; the sex and age of the patient, the interval between presentation for medical opinion and enucleation, the size of the melanoma and its position in the eye, the cell type of the melanoma and the presence of extraocular extension. From this analysis it was found that: 1) The overall 15-year relative survival rate following enucleation was 75%. 2) the survival curve flattened out at six years after enucleation indicating relatively few melanoma-related deaths for the remainder of the 15-year period. 3) there was no increase in death rate at 2 years after enucleation. 4) considering only melanoma-related deaths, increasing age is a strongly depressing influence on survival after enucleation, the 15-year relative survival being 80% for those less than age 40 and only 30% for patients aged 70 and over. 5) submacular melanomas had a very good prognosis for patient survival due in part to their small size and benign cytology. 6) extension into a scleral emissary appeared to exert an unexpectedly depressing effect on prognosis. 7) as in other published series, small melanomas tended to have a good prognosis, and survival rates diminished with increasing size. 8) there was possibility, to be further explored, that ciliary body melanomas may over all have a worse prognosis than melanomas of the choroid.