Background To relate conjunctival melanoma characteristics to local control. Methods Retrospective, registry-based interventional study with data gathered from 10 ophthalmic oncology centres from 9 countries on 4 continents. Conjunctival melanoma patients diagnosed between January 2001 and December 2013 were enrolled in the study. Primary treatments included local excision, excision with cryotherapy and exenteration. Adjuvant treatments included topical chemotherapy, brachytherapy, proton and external beam radiotherapy (EBRT). Cumulative 5-year and 10-year Kaplan-Meier local recurrence rates were related to clinical and pathological T-categories of the eighth edition of the American Joint Committee on Cancer (AJCC) staging system. Results 288 patients had a mean initial age of 59.7±16.8 years. Clinical T-categories (cT) were cT1 (n=218,75.7%), cT2 (n=34, 11.8%), cT3 (n=15, 5.2%), cTx (n=21,7.3%) with no cT4. Primary treatment included local excision (n=161/288, 55.9%) followed by excision biopsy with cryotherapy (n=108/288, 37.5%) and exenteration (n=5/288, 1.7%). Adjuvant therapies included topical mitomycin (n=107/288, 37.1%), plaque-brachytherapy (n=55/288, 19.1%), proton-beam (n=36/288, 13.5%), topical interferon (n=20/288, 6.9%) and EBRT (n=15/288, 5.2%). Secondary exenteration was performed (n=11/283, 3.9%). Local recurrence was noted in 19.1% (median=3.6 years). Cumulative local recurrence was 5.4% (3.2–8.9%), 19.3% (14.4–25.5%) and 36.9% (26.5–49.9%) at 1, 5 and 10 years, respectively. cT3 and cT2 tumors were twice as likely to recur than cT1 tumours, but only cT3 had statistically significantly greater risk of local recurrence than T1 (p=0.013). Factors such as tumour ulceration, plica or caruncle involvement and tumour thickness were not significantly associated with an increased risk of local recurrence. Conclusion This multicentre international study showed that eighth edition of AJCC tumour staging was related to the risk of local recurrence of conjunctival melanoma after treatment. The 10-year cumulative local recurrence remains high despite current management.

中文翻译：

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288 名患者的结膜黑色素瘤治疗结果：一项多中心国际数据共享研究


背景 将结膜黑色素瘤特征与局部控制联系起来。方法 回顾性、基于登记的干预研究，数据收集自 4 大洲 9 个国家的 10 个眼科肿瘤中心。 2001年1月至2013年12月期间诊断的结膜黑色素瘤患者参与了该研究。主要治疗包括局部切除、冷冻治疗切除和切除。辅助治疗包括局部化疗、近距离放射治疗、质子和外照射放射治疗（EBRT）。累积 5 年和 10 年 Kaplan-Meier 局部复发率与美国癌症联合委员会 (AJCC) 分期系统第八版的临床和病理 T 类别相关。结果 288 名患者的平均初始年龄为 59.7±16.8 岁。临床 T 类别 (cT) 为 cT1 (n=218,75.7%)、cT2 (n=34, 11.8%)、cT3 (n=15, 5.2%)、cTx (n=21,7.3%)，无 cT4 。主要治疗包括局部切除（n=161/288，55.9%），随后进行冷冻疗法切除活检（n=108/288，37.5%）和切除术（n=5/288，1.7%）。辅助治疗包括局部丝裂霉素（n=107/288，37.1%）、斑块近距离放射治疗（n=55/288，19.1%）、质子束（n=36/288，13.5%）、局部干扰素（n=20） /288, 6.9%) 和 EBRT (n=15/288, 5.2%)。进行了二次切除（n=11/283，3.9%）。局部复发率为 19.1%（中位=3.6 年）。 1年、5年和10年的累积局部复发率分别为5.4%（3.2-8.9%）、19.3%（14.4-25.5%）和36.9%（26.5-49.9%）。 cT3 和 cT2 肿瘤的复发可能性是 cT1 肿瘤的两倍，但只有 cT3 的局部复发风险在统计学上显着高于 T1 (p=0.013)。 肿瘤溃疡、皱襞或肉阜受累以及肿瘤厚度等因素与局部复发风险增加没有显着相关性。结论 这项多中心国际研究表明，第八版 AJCC 肿瘤分期与结膜黑色素瘤治疗后局部复发的风险相关。尽管采取了目前的治疗措施，10 年累积局部复发率仍然很高。