The Small Fatal Choroidal Melanoma Study. A Survey by the European Ophthalmic Oncology Group

Susanna Jouhi; Martine J Jager; Stefan J R de Geus; Laurence Desjardins; Nils Andreas Eide; Jean-Daniel Grange; Jens Folke Kiilgaard; Stefan Seregard; Edoardo Midena; Raffaele Parrozzani; Jean-Pierre Caujolle; Iwona Rospond-Kubiak; Tero T Kivelä

doi:10.1016/j.ajo.2019.01.031

The Small Fatal Choroidal Melanoma Study. A Survey by the European Ophthalmic Oncology Group

Susanna Jouhi, Martine J Jager, Stefan J R de Geus, Laurence Desjardins, Nils Andreas Eide, Jean-Daniel Grange, Jens Folke Kiilgaard, Stefan Seregard, Edoardo Midena, Raffaele Parrozzani, Jean-Pierre Caujolle, Iwona Rospond-Kubiak, Tero T Kivelä

Department of Clinical Medicine

8 Citations (Scopus)

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Abstract

PURPOSE: To determine the size at which choroidal melanomas can metastasize and to report the characteristics of small fatal choroidal melanomas (SFCM).

DESIGN: Retrospective case series.

METHODS: Ten ocular oncology services submitted 45 patients with a choroidal melanoma 3 mm or less in thickness and 9 mm or less in largest basal diameter (LBD), when treated, who developed metastases.

RESULTS: Median tumor thickness was 2.4 mm (range, 1.0-3.0 mm) and LBD 7.3 mm (range, 3.0-9.0 mm). Of 14 (31%) tumors that were first observed, 12 grew a median of 0.5 mm (range, 0.1-1.2 mm) in thickness and 1.0 mm (range, 0-3.0 mm) in LBD within a median of 7 months; 3 were initially smaller than 3 mm in LBD. Number of risk factors for growth and metastasis was 0 for 4% of the tumors; 60% were over 2 mm in thickness, 63% had subretinal fluid, 84% caused symptoms, 57% had orange pigment, and 92% were within 3 mm of the disc. Local recurrence occurred in 8 of 31 eyes (26%) treated conservatively. Median metastasis-free survival was 4.5 years (range, 0.8-15.7 years). Kaplan-Meier estimate of metastasis developing was 15% (95% confidence interval [CI], 7-26), 51% (95% CI, 36-64) and 85% (95% CI, 71-92) by 2, 5, and 10 years, respectively. By the time of analysis, 37 patients had died of metastasis after a median of 7 months.

CONCLUSIONS: Choroidal melanomas less than 3.0 mm in LBD are highly unlikely to metastasize. Risk factors of an SFCM are similar to those for all choroidal melanomas of similar size.

Original language	English
Journal	American Journal of Ophthalmology
Volume	202
Pages (from-to)	100-108
Number of pages	9
ISSN	0002-9394
DOIs	https://doi.org/10.1016/j.ajo.2019.01.031
Publication status	Published - Jun 2019

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The Small Fatal Choroidal Melanoma Study. A Survey by the European Ophthalmic Oncology GroupFinal published version, 1.15 MBLicence: CC BY-NC-ND

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Jouhi, S., Jager, M. J., de Geus, S. J. R., Desjardins, L., Eide, N. A., Grange, J.-D., Kiilgaard, J. F., Seregard, S., Midena, E., Parrozzani, R., Caujolle, J.-P., Rospond-Kubiak, I., & Kivelä, T. T. (2019). The Small Fatal Choroidal Melanoma Study. A Survey by the European Ophthalmic Oncology Group. American Journal of Ophthalmology, 202, 100-108. https://doi.org/10.1016/j.ajo.2019.01.031

Jouhi, S, Jager, MJ, de Geus, SJR, Desjardins, L, Eide, NA, Grange, J-D, Kiilgaard, JF, Seregard, S, Midena, E, Parrozzani, R, Caujolle, J-P, Rospond-Kubiak, I & Kivelä, TT 2019, 'The Small Fatal Choroidal Melanoma Study. A Survey by the European Ophthalmic Oncology Group', American Journal of Ophthalmology, vol. 202, pp. 100-108. https://doi.org/10.1016/j.ajo.2019.01.031

@article{2a7c33878e444c4a81381fdd623ed942,

title = "The Small Fatal Choroidal Melanoma Study. A Survey by the European Ophthalmic Oncology Group",

abstract = "PURPOSE: To determine the size at which choroidal melanomas can metastasize and to report the characteristics of small fatal choroidal melanomas (SFCM).DESIGN: Retrospective case series.METHODS: Ten ocular oncology services submitted 45 patients with a choroidal melanoma 3 mm or less in thickness and 9 mm or less in largest basal diameter (LBD), when treated, who developed metastases.RESULTS: Median tumor thickness was 2.4 mm (range, 1.0-3.0 mm) and LBD 7.3 mm (range, 3.0-9.0 mm). Of 14 (31%) tumors that were first observed, 12 grew a median of 0.5 mm (range, 0.1-1.2 mm) in thickness and 1.0 mm (range, 0-3.0 mm) in LBD within a median of 7 months; 3 were initially smaller than 3 mm in LBD. Number of risk factors for growth and metastasis was 0 for 4% of the tumors; 60% were over 2 mm in thickness, 63% had subretinal fluid, 84% caused symptoms, 57% had orange pigment, and 92% were within 3 mm of the disc. Local recurrence occurred in 8 of 31 eyes (26%) treated conservatively. Median metastasis-free survival was 4.5 years (range, 0.8-15.7 years). Kaplan-Meier estimate of metastasis developing was 15% (95% confidence interval [CI], 7-26), 51% (95% CI, 36-64) and 85% (95% CI, 71-92) by 2, 5, and 10 years, respectively. By the time of analysis, 37 patients had died of metastasis after a median of 7 months.CONCLUSIONS: Choroidal melanomas less than 3.0 mm in LBD are highly unlikely to metastasize. Risk factors of an SFCM are similar to those for all choroidal melanomas of similar size.",

author = "Susanna Jouhi and Jager, {Martine J} and {de Geus}, {Stefan J R} and Laurence Desjardins and Eide, {Nils Andreas} and Jean-Daniel Grange and Kiilgaard, {Jens Folke} and Stefan Seregard and Edoardo Midena and Raffaele Parrozzani and Jean-Pierre Caujolle and Iwona Rospond-Kubiak and Kivel{\"a}, {Tero T}",

year = "2019",

month = jun,

doi = "10.1016/j.ajo.2019.01.031",

language = "English",

volume = "202",

pages = "100--108",

journal = "American Journal of Ophthalmology",

issn = "0002-9394",

publisher = "Elsevier",

}

TY - JOUR

T1 - The Small Fatal Choroidal Melanoma Study. A Survey by the European Ophthalmic Oncology Group

AU - Jouhi, Susanna

AU - Jager, Martine J

AU - de Geus, Stefan J R

AU - Desjardins, Laurence

AU - Eide, Nils Andreas

AU - Grange, Jean-Daniel

AU - Kiilgaard, Jens Folke

AU - Seregard, Stefan

AU - Midena, Edoardo

AU - Parrozzani, Raffaele

AU - Caujolle, Jean-Pierre

AU - Rospond-Kubiak, Iwona

AU - Kivelä, Tero T

PY - 2019/6

Y1 - 2019/6

N2 - PURPOSE: To determine the size at which choroidal melanomas can metastasize and to report the characteristics of small fatal choroidal melanomas (SFCM).DESIGN: Retrospective case series.METHODS: Ten ocular oncology services submitted 45 patients with a choroidal melanoma 3 mm or less in thickness and 9 mm or less in largest basal diameter (LBD), when treated, who developed metastases.RESULTS: Median tumor thickness was 2.4 mm (range, 1.0-3.0 mm) and LBD 7.3 mm (range, 3.0-9.0 mm). Of 14 (31%) tumors that were first observed, 12 grew a median of 0.5 mm (range, 0.1-1.2 mm) in thickness and 1.0 mm (range, 0-3.0 mm) in LBD within a median of 7 months; 3 were initially smaller than 3 mm in LBD. Number of risk factors for growth and metastasis was 0 for 4% of the tumors; 60% were over 2 mm in thickness, 63% had subretinal fluid, 84% caused symptoms, 57% had orange pigment, and 92% were within 3 mm of the disc. Local recurrence occurred in 8 of 31 eyes (26%) treated conservatively. Median metastasis-free survival was 4.5 years (range, 0.8-15.7 years). Kaplan-Meier estimate of metastasis developing was 15% (95% confidence interval [CI], 7-26), 51% (95% CI, 36-64) and 85% (95% CI, 71-92) by 2, 5, and 10 years, respectively. By the time of analysis, 37 patients had died of metastasis after a median of 7 months.CONCLUSIONS: Choroidal melanomas less than 3.0 mm in LBD are highly unlikely to metastasize. Risk factors of an SFCM are similar to those for all choroidal melanomas of similar size.

AB - PURPOSE: To determine the size at which choroidal melanomas can metastasize and to report the characteristics of small fatal choroidal melanomas (SFCM).DESIGN: Retrospective case series.METHODS: Ten ocular oncology services submitted 45 patients with a choroidal melanoma 3 mm or less in thickness and 9 mm or less in largest basal diameter (LBD), when treated, who developed metastases.RESULTS: Median tumor thickness was 2.4 mm (range, 1.0-3.0 mm) and LBD 7.3 mm (range, 3.0-9.0 mm). Of 14 (31%) tumors that were first observed, 12 grew a median of 0.5 mm (range, 0.1-1.2 mm) in thickness and 1.0 mm (range, 0-3.0 mm) in LBD within a median of 7 months; 3 were initially smaller than 3 mm in LBD. Number of risk factors for growth and metastasis was 0 for 4% of the tumors; 60% were over 2 mm in thickness, 63% had subretinal fluid, 84% caused symptoms, 57% had orange pigment, and 92% were within 3 mm of the disc. Local recurrence occurred in 8 of 31 eyes (26%) treated conservatively. Median metastasis-free survival was 4.5 years (range, 0.8-15.7 years). Kaplan-Meier estimate of metastasis developing was 15% (95% confidence interval [CI], 7-26), 51% (95% CI, 36-64) and 85% (95% CI, 71-92) by 2, 5, and 10 years, respectively. By the time of analysis, 37 patients had died of metastasis after a median of 7 months.CONCLUSIONS: Choroidal melanomas less than 3.0 mm in LBD are highly unlikely to metastasize. Risk factors of an SFCM are similar to those for all choroidal melanomas of similar size.

U2 - 10.1016/j.ajo.2019.01.031

DO - 10.1016/j.ajo.2019.01.031

M3 - Journal article

C2 - 30772347

SN - 0002-9394

VL - 202

SP - 100

EP - 108

JO - American Journal of Ophthalmology

JF - American Journal of Ophthalmology

ER -

The Small Fatal Choroidal Melanoma Study. A Survey by the European Ophthalmic Oncology Group

Abstract

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