International validation of the American Joint Committee on Cancer's 7th edition classification of uveal melanoma

E. Rand Simpson, Brenda L. Gallie, Svetlana Saakyan, Anush Amiryan, Paul T. Finger, Kimberly J. Chin, Stefan Seregard, Maria Fili, Matthew Wilson, Barrett Haik, Jose M. Caminal, Jaume Catala, David E. Pelayes, Anibal M. Folgar, Martine Jager, Mehmet Dogrusöz, Arun Singh, Andrew Schachat, Shigenobu Suzuki, Yukiko Aihara

Research output: Contribution to journalArticle

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Abstract

IMPORTANCE: Although an accurate uveal melanoma staging system is needed to improve research and patient care, the evaluation of eye cancer staging systems requires international multicenter data sharing to acquire a statistically significant analysis. OBJECTIVE: To assess patient mortality outcomes associated with uveal melanoma staging according to the 7th edition of the American Joint Committee on Cancer's AJCC Cancer Staging Manual. DESIGN, SETTING, PARTICIPANTS: A committee was formed to create patient-specific data fields for patients with uveal melanoma. Ten subspecialty ophthalmic oncology centers from 4 continents shared data. Patient selection criteria included diagnosis of uveal melanoma from April 1, 2001, to April 1, 2011, adequate records to allow tumor staging by the AJCC criteria, and follow-up for metastatic melanoma. INTERVENTIONS: Primary treatments included local resection, radiation therapy, and enucleation. MAIN OUTCOMES AND MEASURES: Metastasis after initial tumor staging with 5- and 10-year Kaplan-Meier metastasis-free point estimates, depending on AJCC prognostic stages I through IV, tumor size category, and subclassification (defined by the presence of ciliary body involvement and/or extrascleral extension). RESULTS: A total of 3809 patients were entered into the database. Of these, 3377 records (88.7%) were complete. Primary ciliary body and choroidal melanoma was the diagnosis for 3217, and 160 had primary iris melanoma. Tumor size categories were T1 in 1115 (34.7%) of the 3217 patients, T2 in 1128 patients (35.1%), T3 in 789 patients (24.5%), and T4 in 185 patients (5.8%). The 5- and 10-year Kaplan-Meier metastasis-free point estimates by tumor size categories were 97% (95% CI, 95%-98%) and 94% (95% CI, 91%-96%) for T1 tumors, 85% (95% CI, 82%-88%) and 80% (95% CI, 75%-84%) for T2 tumors, 77% (95% CI, 73%-80%) and 68% (95% CI, 60%-74%) for T3 tumors, and 61% (95% CI, 49%-71%) (5-year only) for T4 tumors, respectively. Increasing tumor size was consistent with increased metastasis risk (P <.001). Subclassifications were significantly associated with increased risk of metastasis (P <.001). The AJCC prognostic and anatomical groupings were as follows: stage I, 1030 (32.0%); stage IIA, 1095 (34.0%); stage IIB, 710 (22.1%); stage IIIA, 282 (8.8%); stage IIIB, 79 (2.5%); and stage IIIC, 21 (0.7%). The 5- and 10-year Kaplan-Meier metastasis-free estimates for prognostic stages were 97% (95% CI, 95%-98%) and 94% (95% CI, 91%-96%) for stage I, 89% (95% CI, 86%-91%) and 84% (95% CI, 80%-88%) for stage IIA, 79% (95% CI, 75%-83%) and 70% (95% CI, 62%-76%) for stage IIB, 67% (95% CI, 59%-73%) and 60% (95%CI, 51%-68%) forstage IIIA, 50% (95% CI, 33%-65%) and 50%(95%CI, 33%-65%) for stage IIIB, and 25% (95% CI, 4%-53%) (5-year only) for stage IIIC, respectively. The 160 iris melanomas were too few for subgroup analysis. CONCLUSIONS AND RELEVANCE: Multicenter, worldwide, Internet-based data sharing was used to study a heterogenous patient population in ophthalmic oncology. Our results support the continued use of the 7th edition of the AJCC Cancer Staging Manual for uveal melanoma.

Original languageEnglish (US)
Pages (from-to)376-383
Number of pages8
JournalJAMA Ophthalmology
Volume133
Issue number4
DOIs
StatePublished - Apr 1 2015

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Neoplasm Staging
Neoplasm Metastasis
Neoplasms
Melanoma
Ciliary Body
Information Dissemination
Iris
Patient Selection
Eye Neoplasms
Uveal melanoma
Internet
Patient Care
Radiotherapy
Databases
Mortality
Research
Population

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Cite this

Rand Simpson, E., Gallie, B. L., Saakyan, S., Amiryan, A., Finger, P. T., Chin, K. J., ... Aihara, Y. (2015). International validation of the American Joint Committee on Cancer's 7th edition classification of uveal melanoma. JAMA Ophthalmology, 133(4), 376-383. https://doi.org/10.1001/jamaophthalmol.2014.5395

International validation of the American Joint Committee on Cancer's 7th edition classification of uveal melanoma. / Rand Simpson, E.; Gallie, Brenda L.; Saakyan, Svetlana; Amiryan, Anush; Finger, Paul T.; Chin, Kimberly J.; Seregard, Stefan; Fili, Maria; Wilson, Matthew; Haik, Barrett; Caminal, Jose M.; Catala, Jaume; Pelayes, David E.; Folgar, Anibal M.; Jager, Martine; Dogrusöz, Mehmet; Singh, Arun; Schachat, Andrew; Suzuki, Shigenobu; Aihara, Yukiko.

In: JAMA Ophthalmology, Vol. 133, No. 4, 01.04.2015, p. 376-383.

Research output: Contribution to journalArticle

Rand Simpson, E, Gallie, BL, Saakyan, S, Amiryan, A, Finger, PT, Chin, KJ, Seregard, S, Fili, M, Wilson, M, Haik, B, Caminal, JM, Catala, J, Pelayes, DE, Folgar, AM, Jager, M, Dogrusöz, M, Singh, A, Schachat, A, Suzuki, S & Aihara, Y 2015, 'International validation of the American Joint Committee on Cancer's 7th edition classification of uveal melanoma', JAMA Ophthalmology, vol. 133, no. 4, pp. 376-383. https://doi.org/10.1001/jamaophthalmol.2014.5395
Rand Simpson, E. ; Gallie, Brenda L. ; Saakyan, Svetlana ; Amiryan, Anush ; Finger, Paul T. ; Chin, Kimberly J. ; Seregard, Stefan ; Fili, Maria ; Wilson, Matthew ; Haik, Barrett ; Caminal, Jose M. ; Catala, Jaume ; Pelayes, David E. ; Folgar, Anibal M. ; Jager, Martine ; Dogrusöz, Mehmet ; Singh, Arun ; Schachat, Andrew ; Suzuki, Shigenobu ; Aihara, Yukiko. / International validation of the American Joint Committee on Cancer's 7th edition classification of uveal melanoma. In: JAMA Ophthalmology. 2015 ; Vol. 133, No. 4. pp. 376-383.
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abstract = "IMPORTANCE: Although an accurate uveal melanoma staging system is needed to improve research and patient care, the evaluation of eye cancer staging systems requires international multicenter data sharing to acquire a statistically significant analysis. OBJECTIVE: To assess patient mortality outcomes associated with uveal melanoma staging according to the 7th edition of the American Joint Committee on Cancer's AJCC Cancer Staging Manual. DESIGN, SETTING, PARTICIPANTS: A committee was formed to create patient-specific data fields for patients with uveal melanoma. Ten subspecialty ophthalmic oncology centers from 4 continents shared data. Patient selection criteria included diagnosis of uveal melanoma from April 1, 2001, to April 1, 2011, adequate records to allow tumor staging by the AJCC criteria, and follow-up for metastatic melanoma. INTERVENTIONS: Primary treatments included local resection, radiation therapy, and enucleation. MAIN OUTCOMES AND MEASURES: Metastasis after initial tumor staging with 5- and 10-year Kaplan-Meier metastasis-free point estimates, depending on AJCC prognostic stages I through IV, tumor size category, and subclassification (defined by the presence of ciliary body involvement and/or extrascleral extension). RESULTS: A total of 3809 patients were entered into the database. Of these, 3377 records (88.7{\%}) were complete. Primary ciliary body and choroidal melanoma was the diagnosis for 3217, and 160 had primary iris melanoma. Tumor size categories were T1 in 1115 (34.7{\%}) of the 3217 patients, T2 in 1128 patients (35.1{\%}), T3 in 789 patients (24.5{\%}), and T4 in 185 patients (5.8{\%}). The 5- and 10-year Kaplan-Meier metastasis-free point estimates by tumor size categories were 97{\%} (95{\%} CI, 95{\%}-98{\%}) and 94{\%} (95{\%} CI, 91{\%}-96{\%}) for T1 tumors, 85{\%} (95{\%} CI, 82{\%}-88{\%}) and 80{\%} (95{\%} CI, 75{\%}-84{\%}) for T2 tumors, 77{\%} (95{\%} CI, 73{\%}-80{\%}) and 68{\%} (95{\%} CI, 60{\%}-74{\%}) for T3 tumors, and 61{\%} (95{\%} CI, 49{\%}-71{\%}) (5-year only) for T4 tumors, respectively. Increasing tumor size was consistent with increased metastasis risk (P <.001). Subclassifications were significantly associated with increased risk of metastasis (P <.001). The AJCC prognostic and anatomical groupings were as follows: stage I, 1030 (32.0{\%}); stage IIA, 1095 (34.0{\%}); stage IIB, 710 (22.1{\%}); stage IIIA, 282 (8.8{\%}); stage IIIB, 79 (2.5{\%}); and stage IIIC, 21 (0.7{\%}). The 5- and 10-year Kaplan-Meier metastasis-free estimates for prognostic stages were 97{\%} (95{\%} CI, 95{\%}-98{\%}) and 94{\%} (95{\%} CI, 91{\%}-96{\%}) for stage I, 89{\%} (95{\%} CI, 86{\%}-91{\%}) and 84{\%} (95{\%} CI, 80{\%}-88{\%}) for stage IIA, 79{\%} (95{\%} CI, 75{\%}-83{\%}) and 70{\%} (95{\%} CI, 62{\%}-76{\%}) for stage IIB, 67{\%} (95{\%} CI, 59{\%}-73{\%}) and 60{\%} (95{\%}CI, 51{\%}-68{\%}) forstage IIIA, 50{\%} (95{\%} CI, 33{\%}-65{\%}) and 50{\%}(95{\%}CI, 33{\%}-65{\%}) for stage IIIB, and 25{\%} (95{\%} CI, 4{\%}-53{\%}) (5-year only) for stage IIIC, respectively. The 160 iris melanomas were too few for subgroup analysis. CONCLUSIONS AND RELEVANCE: Multicenter, worldwide, Internet-based data sharing was used to study a heterogenous patient population in ophthalmic oncology. Our results support the continued use of the 7th edition of the AJCC Cancer Staging Manual for uveal melanoma.",
author = "{Rand Simpson}, E. and Gallie, {Brenda L.} and Svetlana Saakyan and Anush Amiryan and Finger, {Paul T.} and Chin, {Kimberly J.} and Stefan Seregard and Maria Fili and Matthew Wilson and Barrett Haik and Caminal, {Jose M.} and Jaume Catala and Pelayes, {David E.} and Folgar, {Anibal M.} and Martine Jager and Mehmet Dogrus{\"o}z and Arun Singh and Andrew Schachat and Shigenobu Suzuki and Yukiko Aihara",
year = "2015",
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TY - JOUR

T1 - International validation of the American Joint Committee on Cancer's 7th edition classification of uveal melanoma

AU - Rand Simpson, E.

AU - Gallie, Brenda L.

AU - Saakyan, Svetlana

AU - Amiryan, Anush

AU - Finger, Paul T.

AU - Chin, Kimberly J.

AU - Seregard, Stefan

AU - Fili, Maria

AU - Wilson, Matthew

AU - Haik, Barrett

AU - Caminal, Jose M.

AU - Catala, Jaume

AU - Pelayes, David E.

AU - Folgar, Anibal M.

AU - Jager, Martine

AU - Dogrusöz, Mehmet

AU - Singh, Arun

AU - Schachat, Andrew

AU - Suzuki, Shigenobu

AU - Aihara, Yukiko

PY - 2015/4/1

Y1 - 2015/4/1

N2 - IMPORTANCE: Although an accurate uveal melanoma staging system is needed to improve research and patient care, the evaluation of eye cancer staging systems requires international multicenter data sharing to acquire a statistically significant analysis. OBJECTIVE: To assess patient mortality outcomes associated with uveal melanoma staging according to the 7th edition of the American Joint Committee on Cancer's AJCC Cancer Staging Manual. DESIGN, SETTING, PARTICIPANTS: A committee was formed to create patient-specific data fields for patients with uveal melanoma. Ten subspecialty ophthalmic oncology centers from 4 continents shared data. Patient selection criteria included diagnosis of uveal melanoma from April 1, 2001, to April 1, 2011, adequate records to allow tumor staging by the AJCC criteria, and follow-up for metastatic melanoma. INTERVENTIONS: Primary treatments included local resection, radiation therapy, and enucleation. MAIN OUTCOMES AND MEASURES: Metastasis after initial tumor staging with 5- and 10-year Kaplan-Meier metastasis-free point estimates, depending on AJCC prognostic stages I through IV, tumor size category, and subclassification (defined by the presence of ciliary body involvement and/or extrascleral extension). RESULTS: A total of 3809 patients were entered into the database. Of these, 3377 records (88.7%) were complete. Primary ciliary body and choroidal melanoma was the diagnosis for 3217, and 160 had primary iris melanoma. Tumor size categories were T1 in 1115 (34.7%) of the 3217 patients, T2 in 1128 patients (35.1%), T3 in 789 patients (24.5%), and T4 in 185 patients (5.8%). The 5- and 10-year Kaplan-Meier metastasis-free point estimates by tumor size categories were 97% (95% CI, 95%-98%) and 94% (95% CI, 91%-96%) for T1 tumors, 85% (95% CI, 82%-88%) and 80% (95% CI, 75%-84%) for T2 tumors, 77% (95% CI, 73%-80%) and 68% (95% CI, 60%-74%) for T3 tumors, and 61% (95% CI, 49%-71%) (5-year only) for T4 tumors, respectively. Increasing tumor size was consistent with increased metastasis risk (P <.001). Subclassifications were significantly associated with increased risk of metastasis (P <.001). The AJCC prognostic and anatomical groupings were as follows: stage I, 1030 (32.0%); stage IIA, 1095 (34.0%); stage IIB, 710 (22.1%); stage IIIA, 282 (8.8%); stage IIIB, 79 (2.5%); and stage IIIC, 21 (0.7%). The 5- and 10-year Kaplan-Meier metastasis-free estimates for prognostic stages were 97% (95% CI, 95%-98%) and 94% (95% CI, 91%-96%) for stage I, 89% (95% CI, 86%-91%) and 84% (95% CI, 80%-88%) for stage IIA, 79% (95% CI, 75%-83%) and 70% (95% CI, 62%-76%) for stage IIB, 67% (95% CI, 59%-73%) and 60% (95%CI, 51%-68%) forstage IIIA, 50% (95% CI, 33%-65%) and 50%(95%CI, 33%-65%) for stage IIIB, and 25% (95% CI, 4%-53%) (5-year only) for stage IIIC, respectively. The 160 iris melanomas were too few for subgroup analysis. CONCLUSIONS AND RELEVANCE: Multicenter, worldwide, Internet-based data sharing was used to study a heterogenous patient population in ophthalmic oncology. Our results support the continued use of the 7th edition of the AJCC Cancer Staging Manual for uveal melanoma.

AB - IMPORTANCE: Although an accurate uveal melanoma staging system is needed to improve research and patient care, the evaluation of eye cancer staging systems requires international multicenter data sharing to acquire a statistically significant analysis. OBJECTIVE: To assess patient mortality outcomes associated with uveal melanoma staging according to the 7th edition of the American Joint Committee on Cancer's AJCC Cancer Staging Manual. DESIGN, SETTING, PARTICIPANTS: A committee was formed to create patient-specific data fields for patients with uveal melanoma. Ten subspecialty ophthalmic oncology centers from 4 continents shared data. Patient selection criteria included diagnosis of uveal melanoma from April 1, 2001, to April 1, 2011, adequate records to allow tumor staging by the AJCC criteria, and follow-up for metastatic melanoma. INTERVENTIONS: Primary treatments included local resection, radiation therapy, and enucleation. MAIN OUTCOMES AND MEASURES: Metastasis after initial tumor staging with 5- and 10-year Kaplan-Meier metastasis-free point estimates, depending on AJCC prognostic stages I through IV, tumor size category, and subclassification (defined by the presence of ciliary body involvement and/or extrascleral extension). RESULTS: A total of 3809 patients were entered into the database. Of these, 3377 records (88.7%) were complete. Primary ciliary body and choroidal melanoma was the diagnosis for 3217, and 160 had primary iris melanoma. Tumor size categories were T1 in 1115 (34.7%) of the 3217 patients, T2 in 1128 patients (35.1%), T3 in 789 patients (24.5%), and T4 in 185 patients (5.8%). The 5- and 10-year Kaplan-Meier metastasis-free point estimates by tumor size categories were 97% (95% CI, 95%-98%) and 94% (95% CI, 91%-96%) for T1 tumors, 85% (95% CI, 82%-88%) and 80% (95% CI, 75%-84%) for T2 tumors, 77% (95% CI, 73%-80%) and 68% (95% CI, 60%-74%) for T3 tumors, and 61% (95% CI, 49%-71%) (5-year only) for T4 tumors, respectively. Increasing tumor size was consistent with increased metastasis risk (P <.001). Subclassifications were significantly associated with increased risk of metastasis (P <.001). The AJCC prognostic and anatomical groupings were as follows: stage I, 1030 (32.0%); stage IIA, 1095 (34.0%); stage IIB, 710 (22.1%); stage IIIA, 282 (8.8%); stage IIIB, 79 (2.5%); and stage IIIC, 21 (0.7%). The 5- and 10-year Kaplan-Meier metastasis-free estimates for prognostic stages were 97% (95% CI, 95%-98%) and 94% (95% CI, 91%-96%) for stage I, 89% (95% CI, 86%-91%) and 84% (95% CI, 80%-88%) for stage IIA, 79% (95% CI, 75%-83%) and 70% (95% CI, 62%-76%) for stage IIB, 67% (95% CI, 59%-73%) and 60% (95%CI, 51%-68%) forstage IIIA, 50% (95% CI, 33%-65%) and 50%(95%CI, 33%-65%) for stage IIIB, and 25% (95% CI, 4%-53%) (5-year only) for stage IIIC, respectively. The 160 iris melanomas were too few for subgroup analysis. CONCLUSIONS AND RELEVANCE: Multicenter, worldwide, Internet-based data sharing was used to study a heterogenous patient population in ophthalmic oncology. Our results support the continued use of the 7th edition of the AJCC Cancer Staging Manual for uveal melanoma.

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