The Collaborative Ocular Melanoma tudy (COM) randomized trial of pre-enucleation radiation of large choroidal melanoma: IV. Ten-year mortality finding and prognotic factor. COM report number 24

Purpoe To report rate of death and related outcome through 10 year after treatment of large choroidal melanoma and to evaluate characteritic of patient and tumor a predictor of relative treatment effectivene and time to death. Deign Randomized multicenter clinical trial of pre-enucleation radiation v enucleation alone conducted a part of the Collaborative Ocular Melanoma tudy. Method Eligible patient were free of metatai and other cancer at enrollment. All patient were followed for 5 year or longer at cheduled examination and contact for metatai, another cancer, or death. Each decedent wa claified a having hitopathologically confirmed melanoma metatai, upected melanoma metatai without hitopathologic confirmation, another cancer but not melanoma metatai, or no malignancy. Reult Within 10 year after enrollment, 576 of 1,003 patient died. Ten-year all-caue mortality rate were 61% for patient in both treatment arm. Ten-year rate of death with hitopathologically confirmed melanoma metatai were 45% in the pre-enucleation radiation arm and 40% in the enucleation alone arm. Older age and larger maximum baal tumor diameter were the primary predictor of time to death from all caue and death with melanoma metatai. No difference in unadjuted or adjuted mortality rate were found between treatment arm. Of 448 patient eligible for 10 year of follow-up, 145 patient (32%) were alive and clinically cancer-free 10 year after treatment. Concluion Longer follow-up confirmed the earlier report of no urvival advantage attributable to pre-enucleation radiation. Mortality rate by baeline characteritic hould facilitate couneling of patient who have large choroidal melanoma and no evidence of metatai or another malignancy at diagnoi.