Comparison of clinical, echographic, and histopathological measurements from eyes with medium-sized choroidal melanoma in the collaborative ocular melanoma study: COMS report no. 21.
OBJECTIVE
To compare pre-enucleation clinical and echographic measurements with postenucleation histopathological measurements of choroidal melanoma of a size and in a location suitable for iodine 125 brachytherapy.


METHODS
Cross-sectional study of patients with melanoma classified as medium-sized who were assigned to the enucleation arm of the randomized trial of 125I brachytherapy vs enucleation conducted by the Collaborative Ocular Melanoma Study (COMS) Group.


METHODS
Measurements of melanoma dimensions by clinical, echographic, and histopathological examinations were compared for 644 eyes. Outcomes Tumor longest basal diameter and apical height.


RESULTS
Tumor dimensions were available for 644 (98%) of 660 patients who had unilateral medium-sized choroidal melanoma and were randomly assigned to enucleation. The clinical and histopathological measurements of the longest basal diameter agreed within +/-2 mm for 371 eyes (58%). The clinical measurement was less than the histopathological measurement by more than 2 mm in 32 eyes (5%), which occurred more frequently when the tumor was within 2 mm of the optic disc. The echographic and histopathological measurements of apical height agreed within +/-2 mm in 579 eyes (90%); the echographic measurement was less than the histopathological measurement in only 2 cases. Features associated with echographic estimates larger than histopathological measurements were greater tumor height and anterior tumor apex location.


CONCLUSIONS
Our results suggest that tumor measurements made according to COMS protocol were highly reliable in planning radioactive plaque therapy and monitoring changes in tumor size after such treatment.
D001918:Brachytherapy; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D003430:Cross-Sectional Studies; D015353:Eye Enucleation; D006801:Humans; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology*; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology