A recent study evaluated the side effects of conjunctival melanoma based on the 8th edition of the American Joint Committee’s cancer classification and found increased risk of vision loss and melanoma-related complications over time.
The retrospective, interventional case series included 425 patients with conjunctival melanoma, classified as T1 (63%), T2 (18%) and T3 (20%). The researchers found that primary acquired melanosis was more common in T2 and conjunctival nevus was more common in T1 (Table 1).
At the five-year follow-up, the investigators noted that more severe stages of melanoma were associated with a greater chance of local recurrence or new tumor formation, exenteration, locoregional lymph node metastasis, systemic metastasis and death. After 10 years of follow-up, they observed reduced visual acuity of greater than three lines across T categories (32% vs. 42% vs. 63%) and increased melanoma-related complications (Table 2).
The study authors concluded that all conjunctival melanoma patients experienced more severe side effects of the condition as the follow-up period progressed.
Table 1. Cancer Risk by T Category | ||
| Primary acquired melanosis | Conjunctival nevus | |
| T1 | 81% | 20% |
| T2 | 96% | 9% |
| T3 | 81% | 11% |
Table 2. Melanoma-related Complications by Follow-up | ||||||||||
| Local recurrence or new tumor formation | Exenteration | Lymph node metastasis | Systemic metastasis | Death | ||||||
| 5 yrs | 10 yrs | 5 yrs | 10 yrs | 5 yrs | 10 yrs | 5 yrs | 10 yrs | 5 yrs | 10 yrs | |
| T1 | 30% | 47% | 3% | 4% | 2% | 3% | 9% | 13% | 4% | 8% |
| T2 | 43% | 70% | 9% | 24% | 7% | 13% | 25% | 45% | 12% | 22% |
| T3 | 49% | 74% | 28% | 46% | 12% | 25% | 23% | 40% | 18% | 37% |
Shields C, Yaghy A, Dalvin LA, et al. Conjunctival melanoma: outcomes based on the American Joint Committee on Cancer Clinical Classification (8th Edition) of 425 patients at a single ocular oncology center. Asia Pac J Ophthalmol (Phila). December 9, 2020. [Epub ahead of print]. |
