MELANOMA-92 - AN EPIDEMIOLOGIC-STUDY OF U VEAL MELANOMA IN FRANCE

Purpose The purposes of this study were to evaluate the incidence of u veal melanoma in France in 1992, to describe the characteristics of th e tumors in their treatments. Methods This was a retrospective and mul ticentric study. First a questionnaire was sent to 4 575 French ophtha lmologists asking whether they had established a diagnosis of uveal me lanoma during 1992, and if so, to describe the tumor and its managemen t. Then the patients files were reviewed in the specialized treatment center (Paris, Lyon, Nice, Strasbourg, Bordeaux, Clermont-Ferrand). Al l the data were statistically analysed. Results 412 new cases of uveal melanomas were registered (incidence 0.7/100 000) affecting 234 femal es and 178 males. The cases ranged in age from 7 to 93 years (mean 61. 5 years). There were 5 (1 %) isolated tumors of the iris, 75 (18 %) of the ciliary body, either isolated (10 %) either associated to iris an d/or to choroidal tumors and 332 (81 %) choroidal melanomas. 201 (53 % ) tumors were posterior to the equator and 153 (40 %) had a margin at less than 3 mm of the optic disc; 87 (21 %) melanomas were detected in asymptomatic patients. In 29 (7 %) other cases, the diagnosis was est ablished after enlargement of the tumor. In all other eyes, symptoms w ere present. 17 % of the melanomas were T-1 34 % were T-2 et 48 % were T-3. 353 (86 %) melanomas were pigmented 30 (7 %) were achromic and 2 9 (7 %) of the mixed color type. 156 (38 %) tumors were associated wit h a retinal detachment. In 12 cases (3 %), at presentation there was a n extrascleral extension. 9 patients (2 %) had metastases (7 to the li ver, 1 to the lungs and 1 to the lungs and bones). The study of the pa tients residence and work did not show any environmental risk factor. The initial treatment wa protontherapy in 251 patients (63 %), plaque therapy in 91 (23 %), enucleation in 40 (10 %), and other methods in 1 8. Conclusion This was the first epidemiologic study conducted in Fran ce on this subject. It describes the clinical features of the disease, its geographical display and its management in this country.