A recent study evaluated the side effects of conjunctival melanoma based on the 8th edition of the American Joint Committee’s cancer classification and found increased risk of vision loss and melanoma-related complications over time.
The retrospective, interventional case series included 425 patients with conjunctival melanoma, classified as T1 (63%), T2 (18%) and T3 (20%). The researchers found that primary acquired melanosis was more common in T2 and conjunctival nevus was more common in T1 (Table 1).
At the five-year follow-up, the investigators noted that more severe stages of melanoma were associated with a greater chance of local recurrence or new tumor formation, exenteration, locoregional lymph node metastasis, systemic metastasis and death. After 10 years of follow-up, they observed reduced visual acuity of greater than three lines across T categories (32% vs. 42% vs. 63%) and increased melanoma-related complications (Table 2).
The study authors concluded that all conjunctival melanoma patients experienced more severe side effects of the condition as the follow-up period progressed.
Table 1. Cancer Risk by T Category
|Primary acquired melanosis||Conjunctival nevus|
Table 2. Melanoma-related Complications by Follow-up
|Local recurrence or new tumor formation||Exenteration||Lymph node metastasis||Systemic metastasis||Death|
|5 yrs||10 yrs||5 yrs||10 yrs||5 yrs||10 yrs||5 yrs||10 yrs||5 yrs||10 yrs|
Shields C, Yaghy A, Dalvin LA, et al. Conjunctival melanoma: outcomes based on the American Joint Committee on Cancer Clinical Classification (8th Edition) of 425 patients at a single ocular oncology center. Asia Pac J Ophthalmol (Phila). December 9, 2020. [Epub ahead of print].