On the basis of data collected over a period of 22 years from 376 patients enucleated at the Eye Clinic of Karl Marx University, Leipzig because of malignant choroidal melanoma, the prognostic significance and reliability of various histopathological characteristics was investigated. The most significant characteristic proved to be the cell type, followed by the degree of pigmentation, the nature and degree of infiltration of the sclera, and tumor size. The relationship of these parameters to the survival rate was shown to be statistically significant by the mortality tabulation method, contingency tabulation method and rank correlation (Spearman). Furthermore, various correlations between the observed variables were ascertained. This statistical analysis shows that the mitosis has no significant bearing on the prognosis. The five-year metastasis rate was 32.8% and the ten-year rate 40.3%. The metastasis peak of 10.4% occurs in the second postoperative year. After the fifth year the annual mortality rate falls to less than 2% and after the seventh year to less than 1%. The data also indicate that even small, Stage I melanomas metastasize if they are not composed purely of spindle cells. With such tumors the peak metastasis rate shifts to the fourth postoperative year.

Lymphocytic infiltration of melanomas represents an immunological response of the organism to the tumor. In order to establish the prognostic significance of this parameter, 369 cases of malignant choroidal melanoma were investigated in the study reported here with respect to the degree of infiltration. The relationship to survival time and other histopathological parameters was examined by means of the mortality tabulation method. The 84.5% five-year survival rate among patients with melanomas exhibiting intense infiltration was significantly higher than the 70.9% rate among patients with tumors showing little infiltration. This study statistically confirms current conjecture that the degree of lymphocytic infiltration, already proven to be prognostically significant in cutaneous melanoma, is also prognostically significant in choroidal melanoma. No correlations to other histopathological parameters could be demonstrated.