Clinical mapping of conjunctival melanomas

Abstract

Aim: To develop a system for clinically mapping conjunctival melanomas, taking into account the tumour's stage of development, location and extent. Methods: Baseline clinical features of 40 patients with conjunctival melanoma, first treated at our centre between 1993 and 2006, were studied. Maps showing sectorial location and circumferential spread in all areas of conjunctiva were digitally generated from numerical data. Results: The patients (18 female; 22 male) had a median age of 59 years. Three had multiple tumours and 20 had mixed, invasive and intraepithelial disease. The Tumour Node and Metastasis (TNM) T stage was I in 11 patients, II in 20, III in eight and IV in one. The tumour was medial in 19% of eyes with T stages I and II as compared with 67% of eyes with stages III and IV (Mann-Whitney, <0.001). Within each T stage of the TNM system, there was considerable variation in tumour dimensions, circumferential spread and longitudinal extent. Conclusions: A system for clinically mapping conjunctival tumour location and extent has been developed. This revealed tumour variation within TNM T stages and may facilitate better collection of data for multicentre trials.