title: Baseline echographic characteristics of tumors in eyes of patients enrolled in the Collaborative Ocular Melanoma Study: COMS report no. 29.
abstract: OBJECTIVE
  To report baseline echographic characteristics of tumors in patients enrolled in the Collaborative Ocular Melanoma Study (COMS) randomized trials, to determine how often these characteristics matched prespecified criteria for choroidal melanoma, to explore associations between echographic variables, and to compare specific echographic characteristics with pathologic characteristics of tumors in enucleated eyes.
  
  
  METHODS
  Retrospective analyses of baseline data from multicenter randomized clinical trials.
  
  
  METHODS
  Patients enrolled in the COMS large trial or medium tumor trials (N = 2320).
  
  
  METHODS
  Standardized echography was used to document selected characteristics of tumors at baseline. Criteria were established to assess the consistency of echographic features with the diagnosis of melanoma. For eyes assigned to enucleation, the echographic diagnosis and evaluation for extraocular extension by the Echography Center were compared with gradings made by the Pathology Center and Pathology Review Committee.
  
  
  METHODS
  Presence of various echographic and pathologic characteristics.
  
  
  RESULTS
  Two thousand forty-three tumors (88%) exhibited low to medium reflectivity (n = 1409), a mushroom shape (n = 101), or both (n = 533). Tumors with apical height > 10 mm were more likely (P<0.001) to have a mushroom shape and less likely to have a posterior location (P<0.001) than less elevated tumors. One thousand five hundred fifty-nine (99.7%) of 1563 tumors judged by echography to be consistent with the diagnosis of melanoma were confirmed by pathology to be choroidal melanoma. For measurable extrascleral tumors < 1.5 mm in height by pathology, the Echography Center graders judged extrascleral extension as possibly present in only 1 of 16 (6%) tumors, compared with 57% (4/7) of eyes with extrascleral extension measuring > or = 1.5 mm in height.
  
  
  CONCLUSIONS
  Eighty-eight percent of the tumors in the COMS exhibited features characteristic for melanoma: low to medium reflectivity, the classic mushroom shape, or both. Using additional preset criteria, 96% of tumors exhibited baseline echographic characteristics consistent with the diagnosis of melanoma. Echography graders were able to detect extrascleral nodules > or = 1.5 mm in elevation but not minimally elevated extraocular tumor extension. Clinicians and echographers can use these data to improve their understanding of the echographic features of untreated uveal melanomas.
authors.forename: H Culver
authors.initials: HC
authors.lastname: Boldt
authors.forename: Sandra Frazier
authors.initials: SF
authors.lastname: Byrne
authors.forename: Marta Marsh
authors.initials: MM
authors.lastname: Gilson
authors.forename: Paul T
authors.initials: PT
authors.lastname: Finger
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Green
authors.forename: Bradley R
authors.initials: BR
authors.lastname: Straatsma
authors.forename: E Rand
authors.initials: ER
authors.lastname: Simpson
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Hawkins
mesh_terms: D001918:Brachytherapy; D002830:Choroid Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D015353:Eye Enucleation; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012189:Retrospective Studies; D014463:Ultrasonography