Conjunctival melanoma: outcomes based on tumor origin in 382 consecutive cases.
OBJECTIVE
To evaluate prognostic factors based on origin of conjunctival melanoma.


METHODS
Interventional case series.


METHODS
Three hundred eighty-two consecutive patients.


METHODS
Retrospective chart review.


METHODS
Melanoma-related metastasis and death.


RESULTS
The melanoma arose from primary acquired melanosis (PAM; n = 284; 74%), from pre-existing nevus (n = 26; 7%), and de novo (n = 72; 19%). The mean tumor base was 11 mm for melanoma arising from PAM, 6 mm for melanoma arising from nevus, and 10 mm for those arising de novo. At 5 years (10 years), melanoma metastasis occurred in 19% (25%) in melanoma arising from PAM (P = 0.003), 10% (26%) in melanoma from nevus (P = 0.193), and 35% (49%) in those de novo. Factors predictive of metastasis by multivariable analysis included tumor origin de novo (P = 0.001), palpebral location (P<0.001), nodular tumor (P = 0.005), and orbital invasion (P = 0.022). At 5 years (10 years), melanoma-related death occurred in 5% (9%) in melanoma arising from PAM (P<0.001), 0% (9%) in melanoma arising from nevus (P<0.057), and 17% (35%) in those arising de novo. Factors predictive of death by multivariable analysis included tumor origin de novo (P<0.001), fornix location (P = 0.04), and nodular tumor (P = 0.001).


CONCLUSIONS
Melanoma arising de novo carries a higher risk of melanoma-related metastasis and death compared with those cases arising from PAM or nevus.
Shields
Carol L
CL
Ocular Oncology Service, Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. shields@shieldsoncology.com
Markowitz
Jeremy S
JS
Belinsky
Irina
I
Schwartzstein
Hal
H
George
Nina S
NS
Lally
Sara E
SE
Mashayekhi
Arman
A
Shields
Jerry A
JA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003230:Conjunctival Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology*; D008548:Melanosis / Q000473:pathology; D008875:Middle Aged; D009506:Nevus / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate