Prognostic significance of histopathology of primary conjunctival melanoma in Caucasians.
OBJECTIVE
To assess histopathologic prognostic factors relative to clinical ones in predicting local recurrence and survival after primary conjunctival melanoma (CM).


METHODS
85 patients with CM were identified in Finland between 1967 and 2000, and 70 primary tumors were available for histopathologic study. Time to first recurrence and melanoma-related mortality were analyzed.


RESULTS
Absence of epithelioid cells (P=0.033), smaller mean diameter of the ten largest nucleoli (P=0.041) and increasing mitotic count (P=0.042) were associated with shorter time to recurrence. The mean diameter of the ten largest nucleoli, the number of tumor-infiltrating lymphocytes and macrophages, extravascular matrix loops and networks, and microvascular density were unassociated with recurrence. Nonlimbal location (P=0.001), recurrence (P<0.001), and increasing tumor thickness (P=0.007) were associated with mortality. By multivariate Cox regression, a model including recurrence and tumor location fitted best with mortality data.


CONCLUSIONS
Histopathological factors are not consistently associated with survival in CM. Tumor location, thickness, and recurrence are predictors of mortality from CM.
Tuomaala
Seppo
S
Ocular Oncology Service, Department of Ophthalmology, Helsinki University Central Hospital, Helsinki, Finland. seppo.tuomaala@hus.fi
Toivonen
Päivi
P
Al-Jamal
Ranaa
R
Kivelä
Tero
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002466:Cell Nucleolus / Q000473:pathology; D003230:Conjunctival Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D016246:Lymphocytes, Tumor-Infiltrating / Q000473:pathology; D008264:Macrophages / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology*; D008875:Middle Aged; D008940:Mitotic Index; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D011379:Prognosis; D015996:Survival Rate; D044465:White People