Iris melanoma outcomes based on the Cancer Genome Atlas (TCGA) classification in 78 consecutive patients

ABSTRACT

Background

The Cancer Genome Atlas (TCGA) classification of genetic alterations in uveal melanoma is widely used for prognostication. We present novel observations on the impact of TCGA Group specifically for iris melanoma.

Methods

This was a retrospective cohort study at a tertiary referral ocular oncology center. All patients with a diagnosis of iris melanoma who underwent genetic evaluation and assessment for TCGA classification between 20 November 1995 and 5 April 2021 were included. The main outcome measures were visual acuity, secondary glaucoma, tumor recurrence, melanoma-related metastasis and death per TCGA group.

Results

There were a total of 78 patients included. The mean patient age was 49.6 years (median 53.0, range 3.0–85.0), mean tumor basal diameter was 6.7 mm (median 6.0, range 1.5–22.0), and mean tumor thickness was 2.6 mm (median 2.5, range 0.5–8.5). Cytology results confirmed iris melanoma (93%) or were inconclusive (7%). The TCGA groups included Group A (n = 36, 46%), Group B (n = 7, 9%), Group C (n = 34, 44%), and Group D (n = 1, 1%). There was no statistically significant difference in outcomes of visual acuity, tumor thickness reduction, secondary glaucoma, tumor recurrence, melanoma-related metastasis or death per individual TCGA group (A vs. B vs. C vs. D) and per bimodal comparison (A/B vs. C/D).

Conclusions

In this analysis, iris melanoma was classified as TCGA group A or B in 55% and as C or D in 45%. The TCGA classification was not predictive of melanoma-related metastasis or death.

KEYWORDS:

• Iris melanoma
• TCGA
• melanoma
• iris
• uvea
• oncology

Disclosure statement

The authors report no conflicts of interes. The authors alone are responsible for the content and writing of this article.

Author contributions

Elliot Cherkas—data acquisition, data analysis and manuscript preparation

Guy Negretti—research design, data interpretation and manuscript preparation

Jennifer Zeiger—data acquisition and manuscript preparation

Additional information

Funding

Support provided in part by the Eye Tumor Research Foundation, Philadelphia, PA (CLS), Moorfields Eye Charity, London, UK (GN), TFC Frost Charitable Trust, London, UK (GN), and the Worshipful Company of Spectacle Makers Charity, London, UK (GN). The funders had no role in the design and conduct of the study, in the collection, analysis, and interpretation of the data, and in the preparation, review, or approval of the manuscript. Carol L. Shields, M.D. has had full access to all the data in the study and takes responsibility for the integrity of the data.