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Comparison of Uveal Melanoma Growth Rates With Mitotic Index and Mortality

Comparison of Uveal Melanoma Growth Rates With Mitotic Index and Mortality Abstract • Between December 1962 and May 1979, growth of choroidal and ciliary body melanomas was documented in 34 patients prior to enucleation, and in one patient whose eye was obtained at autopsy. Melanoma growth rates in 33 of these 35 eyes were calculated and compared with mitotic index, tumor cytology, tumor size, and mortality. Each melanoma appeared to grow at a constant rate that varied widely in different melanomas. Growth rate correlated with mitotic index. Most large tumors and epithelioid and mixed cell melanomas demonstrated fast growth rates. Most melanomas causing death contained epithelioid cells and were growing rapidly. These findings do not support the conclusion of Zimmerman and colleagues that enucleation is responsible for most metastatic deaths. Rather, it argues against one of the fundamental assumptions on which their conclusion is based, namely, that all melanomas have a relatively uniform slow growth rate prior to enucleation. References 1. Curtin VT, Cavender JC: Natural course of selected melanomas of the choroid and ciliary body . Mod Probl Ophthalmol 1974;12:523-527. 2. Gass JDM: Problems in the differential diagnosis of choroidal nevi and malignant melanomas . Am J Ophthalmol 1977;83:299-323. 3. Curtin VT: Malignant melanoma management , in Brockhurst RJ, Boruchoff SA, Hutchinson BT, et al (eds): Controversy in Ophthalmology . Philadelphia, WB Saunders Co, 1977, pp 635-640. 4. Gass JDM: Observations of suspected choroidal and ciliary body melanomas for evidence of growth prior to enucleation . Ophthalmology 1980;87:523-528.Crossref 5. Char DH, Hogan MJ: Management of small elevated pigmented choroidal lesions . Br J Ophthalmol 1977;61:54-58.Crossref 6. Thomas J, Green WR, Maumenee AE: Small choroidal melanomas: A long-term follow-up study . Arch Ophthalmol 1979;97:861-864.Crossref 7. Zimmerman LE, McLean IW, Foster WD: Does enucleation of an eye containing a malignant melanoma prevent or accelerate the dissemination of tumour cells? Br J Ophthalmol 1978; 62:420-425.Crossref 8. Shields JA, Augsburger JJ, Brady LW, et al: Cobalt plaque therapy of posterior uveal melanomas . Ophthalmology 1982;81:1201-1207.Crossref 9. Gragoudas EF, Goitein M, Verhey L, et al: Proton beam irradiation of uveal melanomas: The results of a five-year study . Arch Ophthalmol 1982;100:928-934.Crossref 10. Foulds WS: Experience of local excision of uveal melanomas . Trans Ophthalmol Soc UK 1977; 97:412-415. 11. Kaplan EL, Meier P: Nonparametric estimation from incomplete observation . J Am Stat Assoc 1958;53:457-481.Crossref 12. Gass JDM: Stereoscopic Atlas of Intraocular Tumors . St Louis, CV Mosby Co, 1972, pp 14, 26, 27. 13. MacIlwaine WA IV, Anderson B Jr, Klintworth GK: Enlargement of a histologically documented choroidal nevus . Am J Ophthalmol 1979; 87:480-486. 14. Barr C, Sipperley JO, Nicholson DH: Small melanomas of the choroid . Arch Ophthalmol 1978;96:1580-1582.Crossref 15. Flocks M, Gerende J II, Zimmerman LE: The size and shape of malignant melanomas of the choroid and ciliary body in relation to prognosis and histologic characteristics . Trans Am Acad Ophthalmol Otolaryngol 1955;59:740-758. 16. McLean IW, Foster WD, Zimmerman LE: Prognostic factors in small malignant melanomas of choroid and ciliary body . Arch Ophthalmol 1977;95:48-58.Crossref 17. Shammas HF, Blodi FC: Prognostic factors in choroidal and ciliary body melanomas . Arch Ophthalmol 1977;95:63-69.Crossref 18. Davidorf FH, Lang JR: The natural history of malignant melanoma of the choroid and ciliary body: Small vs large tumors . Trans Am Acad Ophthalmol Otolaryngol 1975;79:310-320. 19. Warren RM: Prognosis of malignant melanomas of the choroid and ciliary body , in Blodi FC (ed): Current Concepts in Ophthalmology . St Louis, CV Mosby Co, 1974, vol 4, p 160. 20. Seddon JM, Albert DM, Lavin PT, et al: A prognostic factor study of disease-free interval and survival following enucleation for uveal melanoma . Arch Ophthalmol 1983;101:1894-1899.Crossref 21. Breur K: Growth rate and radiosensitivity of human tumours: I. Growth rate of human tumours . Eur J Cancer 1966;2:157-171.Crossref 22. Kusama S, Spratt JS Jr, Donegan WL, et al: The gross rates of growth of human mammary carcinoma . Cancer 1972;30:594-599.Crossref 23. Gass JDM: Changing concepts of natural course and management of uveal melanomas , in Nicholson DH (ed): Ocular Pathology Update . New York, Masson Publishing USA Inc, 1980, pp 227-234. 24. Manschot WA, van Peperzeel HA: Choroidal melanoma: Enucleation or observation? A new approach . Arch Ophthalmol 1980;98:71-77.Crossref 25. Collins VP, Loeffler RK, Tivey H: Observations on growth rates of human tumors . AJR 1956;76:988-1000. 26. Schwartz M: A biomathematical approach to clinical tumor growth . Cancer 1961;14:1272-1294.Crossref 27. Van Peperzeel HA: Patterns of Tumor Growth After Radiation, thesis. Groningen, the Netherlands, 1970. 28. Malaise EP, Chavandra N, Charbit A, et al: Relationship between the growth rate of human metastases, survival, and pathological type . Eur J Cancer 1974;10:451-459.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Comparison of Uveal Melanoma Growth Rates With Mitotic Index and Mortality

Archives of Ophthalmology , Volume 103 (7) – Jul 1, 1985

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Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1985.01050070050028
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Abstract

Abstract • Between December 1962 and May 1979, growth of choroidal and ciliary body melanomas was documented in 34 patients prior to enucleation, and in one patient whose eye was obtained at autopsy. Melanoma growth rates in 33 of these 35 eyes were calculated and compared with mitotic index, tumor cytology, tumor size, and mortality. Each melanoma appeared to grow at a constant rate that varied widely in different melanomas. Growth rate correlated with mitotic index. Most large tumors and epithelioid and mixed cell melanomas demonstrated fast growth rates. Most melanomas causing death contained epithelioid cells and were growing rapidly. These findings do not support the conclusion of Zimmerman and colleagues that enucleation is responsible for most metastatic deaths. Rather, it argues against one of the fundamental assumptions on which their conclusion is based, namely, that all melanomas have a relatively uniform slow growth rate prior to enucleation. References 1. Curtin VT, Cavender JC: Natural course of selected melanomas of the choroid and ciliary body . Mod Probl Ophthalmol 1974;12:523-527. 2. Gass JDM: Problems in the differential diagnosis of choroidal nevi and malignant melanomas . Am J Ophthalmol 1977;83:299-323. 3. Curtin VT: Malignant melanoma management , in Brockhurst RJ, Boruchoff SA, Hutchinson BT, et al (eds): Controversy in Ophthalmology . Philadelphia, WB Saunders Co, 1977, pp 635-640. 4. Gass JDM: Observations of suspected choroidal and ciliary body melanomas for evidence of growth prior to enucleation . Ophthalmology 1980;87:523-528.Crossref 5. Char DH, Hogan MJ: Management of small elevated pigmented choroidal lesions . Br J Ophthalmol 1977;61:54-58.Crossref 6. Thomas J, Green WR, Maumenee AE: Small choroidal melanomas: A long-term follow-up study . Arch Ophthalmol 1979;97:861-864.Crossref 7. Zimmerman LE, McLean IW, Foster WD: Does enucleation of an eye containing a malignant melanoma prevent or accelerate the dissemination of tumour cells? Br J Ophthalmol 1978; 62:420-425.Crossref 8. Shields JA, Augsburger JJ, Brady LW, et al: Cobalt plaque therapy of posterior uveal melanomas . Ophthalmology 1982;81:1201-1207.Crossref 9. Gragoudas EF, Goitein M, Verhey L, et al: Proton beam irradiation of uveal melanomas: The results of a five-year study . Arch Ophthalmol 1982;100:928-934.Crossref 10. Foulds WS: Experience of local excision of uveal melanomas . Trans Ophthalmol Soc UK 1977; 97:412-415. 11. Kaplan EL, Meier P: Nonparametric estimation from incomplete observation . J Am Stat Assoc 1958;53:457-481.Crossref 12. Gass JDM: Stereoscopic Atlas of Intraocular Tumors . St Louis, CV Mosby Co, 1972, pp 14, 26, 27. 13. MacIlwaine WA IV, Anderson B Jr, Klintworth GK: Enlargement of a histologically documented choroidal nevus . Am J Ophthalmol 1979; 87:480-486. 14. Barr C, Sipperley JO, Nicholson DH: Small melanomas of the choroid . Arch Ophthalmol 1978;96:1580-1582.Crossref 15. Flocks M, Gerende J II, Zimmerman LE: The size and shape of malignant melanomas of the choroid and ciliary body in relation to prognosis and histologic characteristics . Trans Am Acad Ophthalmol Otolaryngol 1955;59:740-758. 16. McLean IW, Foster WD, Zimmerman LE: Prognostic factors in small malignant melanomas of choroid and ciliary body . Arch Ophthalmol 1977;95:48-58.Crossref 17. Shammas HF, Blodi FC: Prognostic factors in choroidal and ciliary body melanomas . Arch Ophthalmol 1977;95:63-69.Crossref 18. Davidorf FH, Lang JR: The natural history of malignant melanoma of the choroid and ciliary body: Small vs large tumors . Trans Am Acad Ophthalmol Otolaryngol 1975;79:310-320. 19. Warren RM: Prognosis of malignant melanomas of the choroid and ciliary body , in Blodi FC (ed): Current Concepts in Ophthalmology . St Louis, CV Mosby Co, 1974, vol 4, p 160. 20. Seddon JM, Albert DM, Lavin PT, et al: A prognostic factor study of disease-free interval and survival following enucleation for uveal melanoma . Arch Ophthalmol 1983;101:1894-1899.Crossref 21. Breur K: Growth rate and radiosensitivity of human tumours: I. Growth rate of human tumours . Eur J Cancer 1966;2:157-171.Crossref 22. Kusama S, Spratt JS Jr, Donegan WL, et al: The gross rates of growth of human mammary carcinoma . Cancer 1972;30:594-599.Crossref 23. Gass JDM: Changing concepts of natural course and management of uveal melanomas , in Nicholson DH (ed): Ocular Pathology Update . New York, Masson Publishing USA Inc, 1980, pp 227-234. 24. Manschot WA, van Peperzeel HA: Choroidal melanoma: Enucleation or observation? A new approach . Arch Ophthalmol 1980;98:71-77.Crossref 25. Collins VP, Loeffler RK, Tivey H: Observations on growth rates of human tumors . AJR 1956;76:988-1000. 26. Schwartz M: A biomathematical approach to clinical tumor growth . Cancer 1961;14:1272-1294.Crossref 27. Van Peperzeel HA: Patterns of Tumor Growth After Radiation, thesis. Groningen, the Netherlands, 1970. 28. Malaise EP, Chavandra N, Charbit A, et al: Relationship between the growth rate of human metastases, survival, and pathological type . Eur J Cancer 1974;10:451-459.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Jul 1, 1985

References