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

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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 [East Germany] because of malignant choroidal melanoma, the prognostic significance and reliability of various histopathological characteristics were 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, varius 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.

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