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COMS Report No. 21

Collaborative Ocular Melanoma Study Group^*

Arch Ophthalmol. 2003;121:1163-1171.

Objective  To compare pre-enucleation clinical and echographic measurements with postenucleation histopathological measurements of choroidal melanoma of a size and in a location suitable for iodine 125 brachytherapy.

Design  Cross-sectional study of patients with melanoma classified as medium-sized who were assigned to the enucleation arm of the randomized trial of ¹²⁵I brachytherapy vs enucleation conducted by the Collaborative Ocular Melanoma Study (COMS) Group.

Methods  Measurements of melanoma dimensions by clinical, echographic, and histopathological examinations were compared for 644 eyes.

Outcomes  Tumor longest basal diameter and apical height.

Results  Tumor dimensions were available for 644 (98%) of 660 patients who had unilateral medium-sized choroidal melanoma and were randomly assigned to enucleation. The clinical and histopathological measurements of the longest basal diameter agreed within ±2 mm for 371 eyes (58%). The clinical measurement was less than the histopathological measurement by more than 2 mm in 32 eyes (5%), which occurred more frequently when the tumor was within 2 mm of the optic disc. The echographic and histopathological measurements of apical height agreed within ±2 mm in 579 eyes (90%); the echographic measurement was less than the histopathological measurement in only 2 cases. Features associated with echographic estimates larger than histopathological measurements were greater tumor height and anterior tumor apex location.

Conclusions  Our results suggest that tumor measurements made according to COMS protocol were highly reliable in planning radioactive plaque therapy and monitoring changes in tumor size after such treatment.

^*This report was prepared on behalf of the COMS Group by Marie Diener-West, PhD; Daniel M. Albert, MD; Sandra Frazier Byrne; Frederick H. Davidorf, MD; David Followill, PhD; Ronald L. Green, MD; Barbara S. Hawkins, PhD; Peter K. Kaiser, MD; Dennis M. Robertson, MD; and Bradley R. Straatsma, MD. A complete list of the members of the Collaborative Ocular Melanoma Study Group as of September 30, 2000, was published in Arch Ophthalmol. 2001;119:951-965. The authors have no relevant financial interest in this article.

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