Posterior uveal melanoma in 321 Asian Indian patients: analysis based on the 8th edition of American Joint Committee Can
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ORIGINAL PAPER
Posterior uveal melanoma in 321 Asian Indian patients: analysis based on the 8th edition of American Joint Committee Cancer classification Anasua Ganguly Kapoor . Swathi Kaliki . Vijitha S. Vempuluru . Sai Divya Jajapuram . Mohammad Hasnat Ali . Ashik Mohamed
Received: 21 February 2020 / Accepted: 22 June 2020 Ó Springer Nature B.V. 2020
Abstract Purpose To evaluate the presenting features, treatment, and outcomes of posterior uveal melanoma (PUM) in Asian Indians based on the 8th edition of American Joint Committee on Cancer (AJCC) classification. Methods Retrospective interventional case series of 321 Asian Indian patients with PUM. Results Based on AJCC, PUM was classified into categories T1 (n = 36; 11%), T2 (n = 74; 23%), T3 (n = 126; 39%), and T4 (n = 85; 27%). Regarding tumor features, T4 was more likely to have preequatorial epicenter (vs T1 and T2; p B 0.011), iris abnormalities (vs T2 and T3; p B 0.002), and extraocular tumor extension (vs T3; p = 0.001), whereas T1 was more likely to have macular epicenter (vs T2, T3,
T4; p B 0.013), lipofuscin deposits (vs T3 and T4; p B 0.008), and amelanotic tumors (vs. T4; p = 0.003). On multivariate analysis, factors predictive of systemic metastasis were increasing tumor thickness (p = 0.002) and extraocular tumor extension (p = 0.009). The 5-, 10-, and 15-year melanomarelated metastases rates were 0%, 0%, and 0% in T1, 0%, 60%, and 60% in T2, 7%, 40%, and 70% in T3 and 13%, 36%, and 76% in T4, respectively. Risk for metastasis was 1.23 times more for every 1-mm increase in tumor thickness and 9 times more with extraocular tumor extension. Conclusion The AJCC 8th edition provides prognostic classification for PUM in Asian Indian patients. The significant risk factors for metastasis were increasing tumor thickness and extraocular tumor extension.
A. G. Kapoor V. S. Vempuluru The Operation Eyesight, Universal Institute for Eye Cancer, L V Prasad Eye Institute, Vijayawada, India
Keywords Eye Tumor Uvea Choroid Melanoma Choroidal melanoma AJCC 8th edition
S. Kaliki (&) S. D. Jajapuram The Operation Eyesight, Universal Institute for Eye Cancer, L V Prasad Eye Institute, Hyderabad, India e-mail: [email protected] M. H. Ali Department of Biostatistics, L V Prasad Eye Institute, Hyderabad, India A. Mohamed Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, India
Introduction Cancer staging is the scientific medical language defining the local, regional, and systemic extent of a cancer at a specified time. The American Joint Committee on Cancer (AJCC) established a way of standardized nomenclature called TNM where T is the primary tumor, N the lymph node extension, and M the
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distant metastasis for readily communicating the state of a cancer and to aid in treatment decision making and judging prognosis of cancer. AJCC was established in 1959 and published its first manual for cancer staging in 1977. Since then, a collaborative effort by the AJCC and the
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