The predictive factor for conjunctival melanoma recurrence

https://doi.org/10.19106/JMedSci005104201909

Agus Supartoto(1*), Melita Suwan Djaja(2), Didik Setyo Heriyanto(3), Endang Soetristi(4), Datu Respatika(5), Muhammad Bayu Sasongko(6)

(1) Reconstruction, Oculoplasty, Oncology Subdivision, Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta
(2) Reconstruction, Oculoplasty, Oncology Subdivision, Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta
(3) Reconstruction, Oculoplasty, Oncology Subdivision, Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta
(4) Reconstruction, Oculoplasty, Oncology Subdivision, Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta
(5) Reconstruction, Oculoplasty, Oncology Subdivision, Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta
(6) Reconstruction, Oculoplasty, Oncology Subdivision, Department of Ophthalmology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital, Yogyakarta
(*) Corresponding Author

Abstract


Conjunctival melanoma potentially deadly tumor. While many cases of conjunctival melanoma appeared to be a recurrence, there is no valid data
about parameters to predict the recurrence of this tumor. This study intended to evaluate whether histopathologic features can be used as a predictor
for recurrence in conjunctival melanoma. This was a retrospective study, involving patients with conjunctival melanoma by the year 2013-1017 in Dr.
Sardjito General Hospital and Dr. Yap Eye Hospital, Yogyakarta. Patient’s characteristic was determined by age, sex, laterality, tumor size, tumor location,
histopathological dominancy, MMC application, recurrence, and metastases. Sixteen cases were found: male (62.5%) and female (37.5%). Age from 5-79
years, mean was 56.19 years. Tumor location was in bulbar in 11 patients (68.7%), palpebral in 5 patients (31.3%).There was significant association
between metastasis and the tumor recurrence (OR 13.0; 95% CI 1.9-85.4; p = 0.007). A favorable trend of association was also found between location and
the recurrence of melanoma (OR 15.0; 95% CI 0.9-228.8; p = 0.06). In summary, our study showed that the patients that developing distant metastasis were at a greater risk for tumor recurrence.

Keywords


conjunctival melanoma; recurrence; histopathology; epithelioid; spindle; mixed

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References

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1. Esmaeli B, Roberts D, Ross M, Fellman M, Cruz H, Kim SK, et al. Histologic features of conjunctival melanoma predictive of metastasis and death (an American Ophthalmological thesis). Trans Am Ophthalmol Soc 2012; 110:64.

2. Wiraguna AWA. Incidence of nevus pigmentosus and malignant melanoma at the Department of Anatomical Pathology, Faculty of Medicine Gadjah Mada University. Journal of the Medical Sciences (Berkala ilmu Kedokteran) 1994; 26(01): 37-44.

3. Vora GK, Demirci H, Marr B, Mruthyunjaya P. Advances in the management of conjunctival melanoma. Surv Ophthalmol 2017;62(1):26-42.

https://doi.org/10.1016/j.survophthal.2016.06.001

4. McInnes CW, Bellan L. Conjunctival melanoma. N Engl J Med 2015; 372(19):1844.

https://doi.org/10.1056/NEJMicm1405612

5. Kenawy N, Lake S, Coupland S, Damato B. Conjunctival melanoma and melanocytic intra-epithelial neoplasia. Eye 2013; 27(2):142-52.

https://doi.org/10.1038/eye.2012.254

6. Rosa RH. Ophthalmic pathology and intraocular tumors. Am Acad Ophthalmol 2018.

7. Jovanovic P, Mihajlovic M, Djordjevic-Jocic J, Vlajkovic S, Cekic S, Stefanovic V. Ocular melanoma: an overview of the current status. Int J Clin Exp Pathol 2013; 6(7):1230.

8. Coury JR, Davis BN, Koumas CP, Manzano GS, Dehdashti AR. Histopathological and molecular predictors of growth patterns and recurrence in craniopharyngiomas: a systematic review. Neurosurg Rev 2018; 1-8.

https://doi.org/10.1007/s10143-018-0978-5

9. Marciscano AE, Stemmer-Rachamimov AO, Niemierko A, Larvie M, Curry WT, Barker FG, et al. Benign meningiomas (WHO Grade I) with atypical histological features: correlation of histopathological features with clinical outcomes. J Neurosurg 2016; 124(1):106-14.

https://doi.org/10.3171/2015.1.JNS142228

10. Cottom HE, Bshena FI, Speight PM, Craig GT, Jones AV. Histopathological features that predict the recurrence of odontogenic keratocysts. J Oral Pathol Med 2012; 41(5):408-14.

https://doi.org/10.1111/j.1600-0714.2011.01113.x

11. Wong JR, Nanji AA, Galor A, Karp CL. Management of conjunctival malignant melanoma: a review and update. Expert review of ophthalmology 2014; 9(3):185-204.

https://doi.org/10.1586/17469899.2014.921119

12. Tuomaala S, Toivonen P, Al-Jamal R, Kivelä T. Prognostic Significance of Histopathology of Primary Conjunctival Melanoma in Caucasians. Curr Eye Res 2007; 32(11):939-52.

https://doi.org/10.1080/02713680701648019

13. Anastassiou G, Heiligenhaus A, Bechrakis N, Bader E, Bornfeld N, Steuhl K-P. Prognostic value of clinical and histopathological parameters in conjunctival melanomas: a retrospective study. Br J Ophthalmol 2002; 86(2):163-7.

https://doi.org/10.1136/bjo.86.2.163

14. O’Connell EP, O’Leary DP, Fogarty K, Khan ZJ, Redmond HP. Predictors and patterns of melanoma recurrence following a negative sentinel lymph node biopsy. Melanoma Res 2016;26(1):66-70.

https://doi.org/10.1097/CMR.0000000000000211

15. De Potter P, Shields CL, Shields JA, Menduke H. Clinical predictive factors for development of recurrence and metastasis in conjunctival melanoma: a review of 68 cases. Br J Ophthalmol 1993; 77(10):624-30.

https://doi.org/10.1136/bjo.77.10.624

16. Shields CL, Shields JA, Gündüz K, Cater J, Mercado GV, Gross N, et al. Conjunctival melanoma: risk factors for recurrence, exenteration, metastasis, and death in 150 consecutive patients. Arch Ophthalmol 2000; 118(11):1497-507.

https://doi.org/10.1001/archopht.118.11.1497

17. Tuomaala S, Eskelin S, Tarkkanen A, Kivela T. Population-based assessment of clinical characteristics predicting outcome of conjunctival melanoma in whites. Invest Ophthalmol Vis Sci 2002; 43(11):3399-408.

18. Scoggins CR, Ross MI, Reintgen DS, Noyes RD, Goydos JS, Beitsch PD, et al. Gender-related differences in outcome for melanoma patients. Ann Surg 2006; 243(5):693.

https://doi.org/10.1097/01.sla.0000216771.81362.6b

19. Morgese F, Berardi R, Sampaolesi C, Torniai M, Marcantognini G, Giacchetti A, et al. Gender differences and outcome of melanoma patients. J Transl Med 2015; 13(1):P13.

https://doi.org/10.1186/1479-5876-13-S1-P13

20. Farahi JM, Fazzari M, Braunberger T, Caravaglio JV, Kretowicz A, Wells K, et al. Gender differences in melanoma prognostic factors. Dermatol Online J 2018; 24(4).

21. Campbell RJ. Histological typing of tumours of the eye and its adnexa. Berlin Heidelberg: Springer Science & Business Media; 2012.

22. Karcioglu ZA. Orbital tumors: diagnosis and treatment. New York: Springer; 2014.

https://doi.org/10.1007/978-1-4939-1510-1

23. Kurli M, Finger PT. Topical mitomycin chemotherapy for conjunctival malignant melanoma and primary acquired melanosis with atypia: 12 years' experience. Graefes Arch Clin Exp Ophthalmol 2005; 243(11):1108-14.

https://doi.org/10.1007/s00417-004-1080-y



DOI: https://doi.org/10.19106/JMedSci005104201909

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Copyright (c) 2019 Agus Supartoto, Melita Suwan Djaja, Didik Setyo Heriyanto, Endang Soetristi, Datu Respatika, Muhammad Bayu Sasongko

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