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James J. Augsburger, MD; John W. Gamel, MD; Vincent F. Sardi, MD; Richard A. Greenberg, PhD; Jerry A. Shields, MD; Luther W. Brady, MD

Arch Ophthalmol. 1986;104(5):655-661.

Abstract
• Clinical risk factors were assessed prospectively in a nonrandomized concurrent observational study of 237 patients with posterior uveal malignant melanoma. One hundred forty of these patients were treated with enucleation, and 97 underwent cobalt plaque radiotherapy. Tumor size and location of the anterior tumor margin proved to be the most significant clinical risk factors for death from metastatic melanoma. When Cox proportional hazards modeling was used to adjust for recognized intergroup differences in risk factors, the effect of therapy (enucleation vs cobalt plaque radiotherapy) on survival time was not statistically significant. We discuss the implications of this study for a randomized clinical trial of enucleation vs cobalt plaque therapy or comparable forms of irradiation.

Author Affiliations
From the Oncology Service, Department of Ophthalmology, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia (Drs Augsburger, Sardi, and Shields), the Departments of Ophthalmology (Dr Gamel) and Community Health (Dr Greenberg), University of Louisville School of Medicine, and the Department of Radiation Oncology, Hahnemann University College of Medicine, Philadelphia (Dr Brady).

Footnotes
Accepted for publication Dec 31, 1985.

Presented in part at the American Academy of Ophthalmology Meeting, Atlanta, Nov 14, 1985, and the Association for Research in Vision and Ophthalmology Meeting, Sarasota, Fla, May 9, 1985.

Reprint requests to the Oncology Service, Wills Eye Hospital, Ninth and Walnut streets, Philadelphia, PA 19107 (Dr Augsburger).

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