Die prognostische Relevanz histopathologischer Parameter beim malignen Melanom der Aderhaut unter Anwendung der pTNM-Klassifikation

Abstract

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.

Loss of chromosome 3 alleles and multiplication of chromosome 8 alleles in uveal melanoma

“…Combined data from this study and previous publications (Horsman et al, 1990;Prescher et al, 1990) suggest that there might be some correlation between the occurrence of 8q multiplication and infiltration of the sclera, which has been shown to be a prognostic factor (Gollnitz and Lommatzsch, 1988). Multiplication of 8q material was found in 8 of 11 cases with scleral infiltration, while such multiplications were found in only 3 of 9 cases without scleral infiltration.…”

Epidemiologie, Invasion und Wachstum nicht-iridaler Aderhautmelanome und assoziierte intraokulare Veränderungen: Histologische Untersuchung von 223 Augen

“…In any case intraocular borders manifesting different resistance against tumor invasion and thereby influencing prognosis of the disease have to be penetrated. Changes at the front of tumor invasion like loosening of the cellular union and transformation to a higher malignant cell type seem plausible but could not be demonstrated light- verschiedenen Parameter keine Aussagen gemacht werden konnen und diesbezuglich auf andere Publikationen verwiesen werden mul3 (1,6,12,13,14,20,22,33,34,35,39,45,55,65).…”

“…Unsere epidemiologischen Daten (Geschlecht, Altersverteilung, Seitigkeit) weichen von den in der Literatur beschriebenen (22,35,37,61,65) nur unwesentlich ab, so dalI sie an dieser Stelle keiner weiteren Er-Orterung bedUrfen. Hinsichtlich der Tumorlokalisation (Abb.…”