Metastasis of uveal melanoma millimeter-by-millimeter in 8033 consecutive eyes.
OBJECTIVE
To determine the rate of metastasis of uveal melanoma on the basis of tumor thickness in millimeters.


METHODS
Retrospective medical record review.


RESULTS
The mean (median) patient age was 58 (59) years. A total of 8033 eyes were examined. Of the 285 eyes with iris melanoma, the mean tumor thickness was 2.7 mm and metastasis occurred in 0.5%, 4%, and 7% at 3, 5, and 10 years, respectively. Of the 492 eyes with ciliary body melanoma, the mean tumor thickness was 6.6 mm and metastasis occurred in 12%, 19%, and 33% at 3, 5, and 10 years, respectively. Of the 7256 eyes with choroidal melanoma, the mean tumor thickness was 5.5 mm and metastasis occurred in 8%, 15%, and 25% at 3, 5, and 10 years, respectively. For all uveal melanoma, metastasis at 5, 10, and 20 years was 6%, 12%, and 20% for small melanoma (0-3.0 mm thickness), 14%, 26%, and 37% for medium melanoma (3.1-8.0 mm), and 35%, 49%, and 67% for large melanoma (>8.0 mm). More specifically, metastasis per millimeter increment at 10 years was 6% (0-1.0 mm thickness), 12% (1.1-2.0 mm), 12% (2.1-3.0 mm), 16% (3.1-4.0 mm), 27% (4.1-5.0 mm), 28% (5.1-6.0 mm), 29% (6.1-7.0 mm), 41% (7.1-8.0 mm), 50% (8.1-9.0 mm), 44% (9.1-10.0 mm), and 51% (>10.0 mm). Clinical factors predictive of metastasis by multivariate analysis included increasing patient age, ciliary body location, increasing tumor diameter, increasing tumor thickness, having a brown tumor, and the presence of subretinal fluid, intraocular hemorrhage, or extraocular extension.


CONCLUSIONS
Increasing millimeter thickness of uveal melanoma is associated with increasing risk for metastasis.
Shields
Carol L
CL
Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, 840 Walnut St, Ste 1440, Philadelphia, PA 19107, USA. carol.shields@shieldsoncology.com
Furuta
Minoru
M
Thangappan
Archana
A
Nagori
Saya
S
Mashayekhi
Arman
A
Lally
David R
DR
Kelly
Cecilia C
CC
Rudich
Danielle S
DS
Nagori
Anand V
AV
Wakade
Oojwala A
OA
Mehta
Sonul
S
Forte
Lauren
L
Long
Andrew
A
Dellacava
Elaina F
EF
Kaplan
Bonnie
B
Shields
Jerry A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002648:Child; D002675:Child, Preschool; D017679:Cryotherapy; D015353:Eye Enucleation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced; D017075:Laser Coagulation; D008113:Liver Neoplasms / Q000556:secondary* / Q000628:therapy; D008297:Male; D008545:Melanoma / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D014604:Uveal Neoplasms / Q000473:pathology* / Q000628:therapy; D055815:Young Adult