CHOROIDAL-CILIARY BODY MELANOMA - A MULTIVARIATE SURVIVAL ANALYSIS OFTUMOR LOCATION

Background: Posterior uveal melanomas with ciliary body involvement ha ve greater mortality when compared with choroidal melanomas. This stud y was conducted to determine if this association is due to an independ ent effect or to correlations with other parameters. Methods: From the 4335 cases of uveal melanoma with fellow-up data in the Registry of O phthalmic Pathology, 664 were selected; therefore, approximately two t hirds of the patients died of metastatic melanoma. Ciliary body involv ement was determined by the location of the anterior tumor margin, Kap lan-Meier survival, Cox regression, and Gamel-Boag log-normal regressi on analyses were performed. Covariables included ciliary body involvem ent, largest tumor dimension, mean diameter of the largest ten nucleol i, and modified Callender classification. Results: Kaplan-Meier and un ivariate Cox analyses indicated a significant association between cili ary body involvement and tumor-related death but when included in a mu ltivariate Cox model, ciliary body involvement was not statistically s ignificant. Similarly, when ciliary body involvement was included in a multivariate Gamel-Boag model, ciliary body involvement was not stati stically significant. Melanomas that involve the ciliary body were mor e likely to be larger (Student's t = 10.5; P = 10(-6)), contain larger nucleoli (Student's t = 2.43; P = 0.015), and be of mixed cell type ( chi-square = 17.2; P = 3 X 10(-5)). Conclusions: Ciliary body involvem ent is associated with tumor-related mortality but this association is primarily due to ciliary body tumors being larger with more malignant cytology.