Prognostic factors for survival after enucleation for choroidal melanoma

To evaluate the prognostic value of DNA content-ploidy, agoraphilic nucleol ar organizing regions (AgNORs) and proliferating cell nuclear antigen (PCNA ) for survival among patients with choroidal melanoma choroidal melanomas m anaged by enucleation in 55 patients with a follow-up of 5 years were studi ed. AgNor counts were evaluated by two examiners after sections were specif ically processed. Immunohistochemistry was performed to evaluate PCNA expre ssion. Kaplan-Meier estimation of survival curves, the log-rank test, and C ox regression analysis were used to compare survival according to the above mentioned factors. Five years after enucleation 62% of patients had died. Patients with spindle cell type melanomas had the best and those with epith elioid cell type had the worst survival (p=0.004). Patients with small tumo rs had better survival than those with medium or large tumors (p=0.02). Pat ients having tumors with aneuploid nuclear DNA content had worse survival t han those having tumors with diploid DNA content (p=0.004). A high PCNA lev el correlated with lower survival rates (p=0.02). Patients having a high Ag Nor count had a worse survival than those with lower counts (p=0.02). DNA c ontent, PCNA level, and AgNOR count each showed a clinically significant in fluence on patient survival. However, each of these new evaluated prognosti c factors was strongly related to one or both of the classic prognostic fac tors. It is therefore difficult to separate the effects of the two categori es of prognostic factors. Results of the Cox regression analysis suggested that these newer evaluated prognostic factors provided little additional in formation about patient prognosis.