Abstract
Purpose :
To identify factors predictive of tumor recurrence in patients with conjunctival melanoma.
Methods :
We performed a retrospective review of patients diagnosed with conjunctival melanoma at a single center from April 1974 to September 2019. Recurrence was defined as presence of new tumor at the site of previous melanoma or any other site in the conjunctiva, adnexa, or orbit. Demographic and clinical features of patients with recurrence were compared to those without recurrence using the Mann-Whitney U test and chi-square test. Binomial logistic regression was used to identify factors predictive of tumor recurrence.
Results :
There were 540 patients with conjunctival melanoma, of which 180 (33%) had recurrence. A comparison (no recurrence vs. recurrence) revealed those with recurrence presented with older mean patient age (64.0 vs. 59.2 years, p=0.01), greater frequency of prior conjunctival surgery (71% vs. 79%, p= 0.03), worse mean logMAR visual acuity (0.15 vs. 0.22, p=0.01), lower frequency of corneal involvement (57% vs. 45%, p=0.03), and greater frequency of forniceal (24% vs. 38%, p=0.004), tarsal (23% vs 34%, p=0.02), and eyelid (12% vs. 19%, p=0.04) involvement. Of those with recurrence, mean time to recurrence after date of presentation was 34.3 months (median 19.0, range 0.1-215.4 years). On regression analysis, factors predictive of recurrence included older patient age (p=0.04), history of prior conjunctival surgery (p=0.01), and forniceal involvement (p=0.02). The risk of recurrence increased by 1% (OR=1.01) per 1-year increase in patient age, 86% (OR=1.86) with history of prior conjunctival surgery, and 77% (OR=1.77) with forniceal involvement.
Conclusions :
Factors predictive of conjunctival melanoma recurrence include increasing age, history of prior conjunctival surgery, and forniceal involvement.
This is a 2020 ARVO Annual Meeting abstract.