Metastatic Melanoma Death Rates by Anatomic Site After Proton Beam Irradiation for Uveal Melanoma | Dermatology | JAMA Ophthalmology | JAMA Network
[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 18.206.238.77. Please contact the publisher to request reinstatement.
1.
McLean  MJFoster  WDZimmerman  LE Prognostic factors in small malignant melanomas of choroid and ciliary body.  Arch Ophthalmol. 1977;9548- 58Google ScholarCrossref
2.
Kidd  MNLyness  RWPatterson  CCJohnston  PBArcher  DB Prognostic factors in malignant melanoma of the choroid:a retrospective survey of cases occurring in Northern Ireland between 1965 and 1980.  Trans Ophthalmol Soc U K. 1986;105114- 121Google Scholar
3.
Gragoudas  ESSeddon  JMEgan  KM  et al.  Prognostic factors for metastasis following proton beam irradiation of uveal melanomas.  Ophthalmology. 1986;93675- 680Google ScholarCrossref
4.
Gragoudas  ESeddon  JEgan  K  et al.  Metastasis from uveal melanoma after proton beam irradiation.  Ophthalmology. 1988;95992- 999Google ScholarCrossref
5.
Gragoudas  EEgan  KSeddon  JWalsh  SMunzenrider  J Intraocular recurrence of uveal melanoma after proton beam irradiation.  Ophthalmology. 1992;99760- 766Google ScholarCrossref
6.
McLean  IWAinbinder  DJGamel  JWMcCurdy  JB Choroidal-ciliary body melanoma: a multivariate survival analysis of tumor location.  Ophthalmology. 1995;1021060- 1064Google ScholarCrossref
7.
Collaborative Ocular Melanoma Study Group, Mortality in patients with small choroidal melanoma: COMS Report No. 4.  Arch Ophthalmol. 1997;115886- 893Google ScholarCrossref
8.
Harbour  JChar  DKroll  SQuivey  JCastro  J Metastatic risk for distinct patterns of postirradiation local recurrence of posterior uveal melanoma.  Ophthalmology. 1997;1041785- 1792Google ScholarCrossref
9.
Augsburger  JJCorrea  ZMFreire  JBrady  LW Long-term survival in choroidal and ciliary body melanoma after enucleation versus plaque radiation therapy.  Ophthalmology. 1998;1051670- 1678Google ScholarCrossref
10.
Kroll  SChar  DHQuivey  JCastro  J A comparison of cause-specific melanoma mortality and all-cause mortality in survival analyses after radiation treatment for uveal melanoma.  Ophthalmology. 1998;1052035- 2045Google ScholarCrossref
11.
Egan  KGiovannucci  ELane  AGragoudas  E A prospective study of diet as a prognostic factor in choroidal melanoma [abstract].  Invest Ophthalmol Vis Sci. 1998;39 ((ARVO suppl)) S464Google Scholar
12.
Egan  KMQuinn  JLGragoudas  ES Childbearing history associated with improved survival in choroidal melanoma.  Arch Ophthalmol. 1999;117939- 942Google ScholarCrossref
13.
Char  DHKroll  SMCastro  J Long-term follow-up after uveal melanoma charged particle therapy.  Trans Am Ophthalmol Soc. 1997;95171- 187Google Scholar
14.
Char  DHKroll  SMCastro  J Ten-year follow-up of helium ion therapy for uveal melanoma.  Am J Ophthalmol. 1998;12581- 89Google ScholarCrossref
15.
Glynn  RSeddon  JGragoudas  EEgan  KHart  L Evaluation of tumor regression and other prognostic factors for early and late metastasis after proton irradiation of uveal melanoma.  Ophthalmology. 1989;961566- 1573Google ScholarCrossref
16.
Decker  MCastro  JRLinstadt  DE  et al.  Ciliary body melanoma treated with helium particle irradiation.  Int J Radiat Oncol Biol Phys. 1990;19243- 247Google ScholarCrossref
17.
Rummelt  VFolberg  RWoolson  RFHwang  TPe'er  J Relation between the microcirculation architecture and the aggressive behavior of ciliary body melanomas.  Ophthalmology. 1995;102844- 851Google ScholarCrossref
18.
Prescher  GBornfeld  NHirche  HHorsthemke  BJockel  KHBecher  R Prognostic implications of monosomy 3 in uveal melanoma.  Lancet. 1996;3471222- 1225Google ScholarCrossref
19.
Castro  JRChar  DHPetti  PL  et al.  15 years experience with helium ion radiotherapy for uveal melanoma.  Int J Radiat Oncol Biol Phys. 1997;39989- 996Google ScholarCrossref
20.
Daftari  IKChar  DHVerhey  LJ  et al.  Anterior segment sparing to reduce charged particle radiotherapy complications in uveal melanoma.  Int J Radiat Oncol Biol Phys. 1997;39997- 1010Google ScholarCrossref
21.
Barr  CCMcLean  IWZimmerman  LE Uveal melanoma in children and adolescents.  Arch Ophthalmol. 1981;992133- 2136Google ScholarCrossref
22.
Seddon  JMAlbert  DMLavin  PTRobinson  N A prognostic factor study of disease-free interval and survival following enucleation for uveal melanoma.  Arch Ophthalmol. 1983;1011894- 1899Google ScholarCrossref
23.
Seddon  JMGragoudas  ESEgan  KM  et al.  Relative survival rates after alternative therapies for uveal melanoma.  Ophthalmology. 1990;97769- 777Google ScholarCrossref
24.
Augsburger  JJGamel  JW Clinical prognostic factors in patients with posterior uveal malignant melanoma.  Cancer. 1990;661596- 1600Google ScholarCrossref
25.
Augsburger  JJGamel  JWSardi  VFGreenberg  RAShields  JABrady  LW Enucleation vs cobalt plaque radiotherapy for malignant melanomas of the choroid and ciliary body.  Arch Ophthalmol. 1986;104655- 661Google ScholarCrossref
26.
Summanen  PImmonen  IHeikkonen  JTommila  PLaatikainen  LTarkkanen  A Survival of patients and metastatic and local recurrent tumor growth in malignant melanoma of the uvea after ruthenium plaque radiotherapy.  Ophthalmic Surg. 1993;2482- 90Google Scholar
27.
Seregard  SSpangberg  BJuul  COskarsson  M Prognostic accuracy of the mean of the largest nucleoli, vascular patterns, and PC-10 in posterior uveal melanoma.  Ophthalmology. 1998;105485- 491Google ScholarCrossref
28.
Folberg  RRummelt  VParys-Van Ginderdeuren  R  et al.  The prognostic value of tumor blood vessel morphology in primary uveal melanoma.  Ophthalmology. 1993;1001389- 1398Google ScholarCrossref
29.
Seregard  SKock  E Prognostic indicators following enucleation for posterior uveal melanoma: a multivariate analysis of long-term survival with minimized loss to follow-up.  Acta Ophthalmol Scand. 1995;73340- 344Google ScholarCrossref
30.
Foss  AJCree  IADolin  PJHungerford  JL Modelling uveal melanoma.  Br J Ophthalmol. 1999;83588- 594Google ScholarCrossref
31.
Foss  AJAlexander  RAJefferies  LWHungerford  JLHarris  ALLightman  S Microvessel count predicts survival in uveal melanoma.  Cancer Res. 1996;562900- 2903Google Scholar
32.
Damato  BEPaul  JFoulds  WS Risk factors for metastatic uveal melanoma after trans-scleral local resection.  Br J Ophthalmol. 1996;80109- 116Google ScholarCrossref
33.
Sisley  KRennie  IGCottam  DWPotter  AMPotter  CWRees  RC Cytogenetic findings in six posterior uveal melanomas: involvement of chromosomes 3, 6, and 8.  Genes Chromosomes Cancer. 1990;2205- 209Google ScholarCrossref
34.
Sisley  KCottam  DWRennie  IG  et al.  Non-random abnormalities of chromosomes 3, 6, and 8 associated with posterior uveal melanoma.  Genes Chromosomes Cancer. 1992;5197- 200Google ScholarCrossref
35.
Prescher  GBornfeld  NHorsthemke  BBecher  R Chromosomal aberrations defining uveal melanoma of poor prognosis [letter].  Lancet. 1992;339691- 692Google ScholarCrossref
36.
Horsman  DEWhite  VA Cytogenetic analysis of uveal melanoma: consistent occurrence of monosomy 3 and trisomy 8q.  Cancer. 1993;71811- 819Google ScholarCrossref
37.
Sisley  KRennie  IGParsons  MA  et al.  Abnormalities of chromosomes 3 and 8 in posterior uveal melanoma correlate with prognosis.  Genes Chromosomes Cancer. 1997;1922- 28Google ScholarCrossref
38.
Prescher  GBornfeld  NFriedrichs  WSeeber  SBecher  R Cytogenetics of twelve cases of uveal melanoma and patterns of nonrandom anomalies and isochromosome formation.  Cancer Genet Cytogenet. 1995;8040- 46Google ScholarCrossref
39.
Singh  ADBoghosian-Sell  LWary  KK  et al.  Cytogenetic findings in primary uveal melanoma.  Cancer Genet Cytogenet. 1994;72109- 115Google ScholarCrossref
40.
Rummelt  VFolberg  RRummelt  C  et al.  Microcirculation architecture of melanocytic nevi and malignant melanomas of the ciliary body and choroid: a comparative histopathologic and ultrastructural study.  Ophthalmology. 1994;101718- 727Google ScholarCrossref
41.
Folberg  RMehaffey  MGardner  LMMeyer  MRummelt  VPe'er  J The microcirculation of choroidal and ciliary body melanomas.  Eye. 1997;11227- 238Google ScholarCrossref
42.
Folberg  RPe'er  JGruman  LM  et al.  The morphologic characteristics of tumor blood vessels as a marker of tumor progression in primary human uveal melanoma: a matched case-control study.  Hum Pathol. 1992;231298- 1305Google ScholarCrossref
43.
Pe'er  JRummelt  VMawn  LHwang  TWoolson  RFFolberg  R Mean of the ten largest nucleoli, microcirculation architecture, and prognosis of ciliochoroidal melanomas.  Ophthalmology. 1994;1011227- 1235Google ScholarCrossref
44.
Olsen  KCurtin  V Enucleation and plaque treatment. Albert  DJakobiec  Feds. Principles and Practice of Ophthalmology Clinical Practice Philadelphia, Pa WB Saunders Co1994;3217- 3233Google Scholar
45.
Bron  ATripathi  RTripathi  B Wolff's Anatomy of the Eye and Orbit. 8th ed. London, England Chapman & Hall Medical1997;
46.
Cox  D Regression models and life-tables.  J Roy Stat Soc Ser. 1972;34187- 220Google Scholar
47.
Hosmer  DLemeshow  S Applied Survival Analysis: Regression Modeling of Time to Event.  New York, NY John Wiley & Sons Inc1999;
48.
Grambsch  PTherneau  T Proportional hazards tests and diagnostics based on weighted residuals.  Biometrika. 1994;81515- 526Google ScholarCrossref
49.
StataCorp, Bstrap: Bootstrap Sampling and Estimation: Stata Reference Manual: Release 6.0.  College Station, Tex Stata Press1999;157- 167
50.
Linstadt  DCastro  JChar  D  et al.  Long-term results of helium ion irradiation of uveal melanoma.  Int J Radiat Oncol Biol Phys. 1990;19613- 618Google ScholarCrossref
51.
Sisley  KNichols  CParsons  MAFarr  RRees  RCRennie  IG Clinical applications of chromosome analysis, from fine needle aspiration biopsies, of posterior uveal melanomas.  Eye. 1998;12203- 207Google ScholarCrossref
52.
Speicher  MRPrescher  Gdu Manoir  S  et al.  Chromosomal gains and losses in uveal melanomas detected by comparative genomic hybridization.  Cancer Res. 1994;543817- 3823Google Scholar
53.
Davidorf  FH The melanoma controversy: a comparison of choroidal, cutaneous, and iris melanomas.  Surv Ophthalmol. 1981;25373- 377Google ScholarCrossref
54.
Geisse  LJRoberston  DM Iris melanoma.  Am J Ophthalmol. 1985;99638- 648Google Scholar
55.
Jensen  OA Malignant melanoma of the iris: a 25-year analysis of Danish cases.  Eur J Ophthalmol. 1993;3181- 188Google Scholar
Clinical Sciences
August 2000

Metastatic Melanoma Death Rates by Anatomic Site After Proton Beam Irradiation for Uveal Melanoma

Author Affiliations

From the Retina Service, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston (Drs Gragoudas and Egan and Mr Li); the Department of Biostatistics and Epidemiology, University of Massachusetts, Amherst (Mr Li); and the Department of Epidemiology, Harvard School of Public Health, Boston (Dr Egan).

Arch Ophthalmol. 2000;118(8):1066-1070. doi:10.1001/archopht.118.8.1066
Abstract

Background  Ciliary body location is an established prognostic factor for metastasis-related death from uveal melanoma. We evaluated alternative approaches for classifying this covariate when constructing predictive models of patient survival.

Methods and Design  The analyses were based on a consecutive series of 1848 primary choroidal and/or ciliary body melanoma patients treated with proton beam irradiation (70 cobalt gray equivalent in 5 fractions) at the Harvard Cyclotron Laboratory, Boston, Mass, between July 1975 and December 1995. For each patient, the anatomic site of the tumor was classified according to an estimate of the proportion of the tumor base lying anterior to the ora serrata. Using proportional hazards regression, we estimated relative risk ratios and death rates from melanoma metastasis according to the extent of ciliary body involvement. All estimates were adjusted for other established prognostic factors.

Results  Patients were followed up through April 30, 1998; none were lost to follow-up. Of 1848 patients analyzed, 378 died of melanoma metastasis. The median follow-up period among survivors was 9.5 years. Ciliary body origin (>50% of tumor base anterior to the ora serrata) was positively associated with tumor pigmentation (P<.001), tumor height (P<.001), and extrascleral extension of the tumor (P<.001). Compared with tumors involving only the choroid, melanoma-associated death rates increased with the proportion of the tumor base lying within the ciliary body (P = .006); the multivariate-adjusted relative risk ratio for greater than 75% involvement was 2.30 (95% confidence interval [CI], 1.26-4.23). The covariate-adjusted 5-year death rates for ciliary body origin and choroidal origin were 15.9% (95% CI, 11.3%-21.2%) and 9.8% (95% CI, 8.3%-11.7%), respectively.

Conclusion  Patients with melanomas of presumed ciliary body origin seem to be subject to a higher risk of death resulting from melanoma metastasis.

×