June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
American Joint Committee on Cancer (AJCC) 8th Edition Classification of Primary Iris Melanoma: Outcomes Analysis in 432 Patients
Author Affiliations & Notes
  • Vladislav Pavlovich Bekerman
    Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Maura Di Nicola
    Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Carol L Shields
    Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Carolina Alarcon
    Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Enzo Fulco
    Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Swathi Kaliki
    Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Jerry A Shields
    Ocular Oncology Service, Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Vladislav Bekerman, None; Maura Di Nicola, None; Carol Shields, None; Carolina Alarcon, None; Enzo Fulco, None; Swathi Kaliki, None; Jerry Shields, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4421. doi:
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      Vladislav Pavlovich Bekerman, Maura Di Nicola, Carol L Shields, Carolina Alarcon, Enzo Fulco, Swathi Kaliki, Jerry A Shields; American Joint Committee on Cancer (AJCC) 8th Edition Classification of Primary Iris Melanoma: Outcomes Analysis in 432 Patients. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4421.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To analyze patient outcomes of reduced visual acuity, enucleation, and cancer-related metastasis and death associated with primary iris melanoma based on the new 8th edition of the American Joint Committee on Cancer's (AJCC) Cancer Staging Manual.

Methods : A retrospective chart review of 432 patients with primary iris melanoma was conducted. Clinical, imaging, and pathologic analyses were used to classify each tumor in accordance with the AJCC 8th edition manual. Main outcomes measures included visual acuity reduction (>3 lines Snellen acuity), enucleation, and melanoma-related metastasis and death. Continuous variables were reported using medians, interquartile ranges (IQRs), and ranges. Categorical variables were reported with frequencies.

Results : Median follow up for 432 patients was 1.9 years (IQR, 0.3-6.3 year; range, 0-34.4 years). Classification based on anatomical extension were as follows : T1a (193, 44%), T1b, (66, 15%), T1c (65, 15%), T2a (52, 12%), T2b (2, 1%), T2c (29, 7%), T3 (2, 1%), T4a (23, 5%), T4b (0, 0%). Reduced visual acuity (n=109, without including enucleation) occurred in 36 (19%), 15 (23%), 25 (38%), 17 (33%), 2 (100%) and 10 (34%) patients of T1a, T1b, T1c, T2a, T2b and T2c categories respectively and 4 (17%) in T4a category. Enucleation was necessary in 14 (7%), 11 (17%), 9 (14%), 2 (4%), 1 (50%) and 4 (14%) patients of T1a, T1b, T1c, T2a, T2b and T2c categories respectively and 5 (22%) of T4a category. Metastasis and death were distributed as follows: 1 (1%) and 0 (0%) for category T1a, 2 (3%) and 1 (2%) for T1c, 2 (4%) and 1 (2%) for T2a, 4 (14%) and 3 (10%) for T2c, 8 (35%) and 3 (13%) for T4a, respectively. No patients in category T1b, T2b, and T3 developed metastasis or death from iris melanoma. Furthermore, none of the patients in category T3 experienced visual acuity reduction or required enucleation. Of those with 5-year/10-year follow up (145/60), metastasis occurred in : 2/0 (2%/0%) of T1(112/51), 2/2 (7%/22%) of T2 (27/9), and 3/0 (50%/--) of T4 (6/0).

Conclusions : This is the first large series of outcomes based on the new 8th edition of the AJCC Cancer Staging for iris melanomas.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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