Legacy of the Collaborative Ocular Melanoma Study

A reappraisal of the significance of largest basal diameter of posterior uveal melanoma

“…10,23 As this was not the case, the COMS patient numbers were insufficient to detect any significant differences. 24 Studies on adjuvant systemic chemotherapy in high-risk patients have similar flaws. 25 Figure 3 shows the importance of considering histological and cytogenetic predictors when estimating survival probability: the mortality of patients with an LTD of 15 mm varied greatly according to whether histological and cytogenetic risk factors were found.…”

Translating Uveal Melanoma Cytogenetics Into Clinical Care

“…Any randomized studies on the impact of ocular or systemic treatment on the development of metastatic disease would require genomic tumor typing to avoid "statistical noise" caused by the inclusion of many patients with a nonlethal tumor (as happened with the Collaborative Ocular Melanoma Study). 22 …”

Choroidal melanoma endoresection, dandelions and allegory-based medicine

“…The COMS claimed to have found no statistical difference in survival between brachytherapy and enucleation and no benefit from pre-enucleation radiotherapy 4 5. It would perhaps be more correct to say that the COMS actually failed to find any difference and could not have found a difference even if there was one because of insufficient patient numbers and inadequate follow-up 6. In any case, the COMS conclusions seem to have encouraged what I call the “closing-the-door-after-the-horse-has-bolted allegory.” According to this belief, ocular treatment does not influence survival, because any uveal melanomas with metastatic potential have already metastasised by the time they are detected and treated.…”