Prognostic Significance of Histopathology of Primary Conjunctival Melanoma in Caucasians

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Abstract
To assess histopathologic prognostic factors relative to clinical ones in predicting local recurrence and survival after primary conjunctival melanoma (CM). 85 patients with CM were identified in Finland between 1967 and 2000, and 70 primary tumors were available for histopathologic study. Time to first recurrence and melanoma-related mortality were analyzed. Absence of epithelioid cells (P=0.033), smaller mean diameter of the ten largest nucleoli (P=0.041) and increasing mitotic count (P=0.042) were associated with shorter time to recurrence. The mean diameter of the ten largest nucleoli, the number of tumor-infiltrating lymphocytes and macrophages, extravascular matrix loops and networks, and microvascular density were unassociated with recurrence. Nonlimbal location (P=0.001), recurrence (P<0.001), and increasing tumor thickness (P=0.007) were associated with mortality. By multivariate Cox regression, a model including recurrence and tumor location fitted best with mortality data. Histopathological factors are not consistently associated with survival in CM. Tumor location, thickness, and recurrence are predictors of mortality from CM.