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Uveal Melanoma: The Collaborative Ocular Melanoma Study

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Clinical Ophthalmic Oncology

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Abstract

To date, the Collaborative Ocular Melanoma Study (COMS) remains the largest study ever to be performed in ocular oncology. The COMS enrolled patients from 1986 until 1998, with clinical follow-up continuing until 2003. It was a multicentered study comprised of 43 participating clinical centers in North America with centralized units dealing with echography (North Carolina), photography (Iowa), pathology (Wisconsin), radiation physics (Texas), and general coordination (Maryland). Over a period of years, numerous studies, as well as several editorials, letters, and review articles have been published based on the findings of the COMS that have made a tremendous contribution to the field of ocular oncology. They showed us that for medium-sized tumors, enucleation and plaque brachytherapy with iodine-125 yielded equivalent survival outcomes. The results of this arm of the study imparted huge impacts throughout the continent, and the world, as many centers transitioned to an eye-sparing therapy. Then, they concluded that pre-enucleation radiation did not reduce the mortality rate in patients with large tumors, compared to enucleation alone.

While the COMS answered several questions, there are still several that remain controversial to this date. The COMS did not address the treatment of very small tumors, as these were excluded from the study. Additionally, they did not evaluate treatment of tumors located around the nerve and did not study the utility of radiation therapy for very large tumors.

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References

  1. Markowitz JA, Hawkins BS, Diener-West M, et al. A review of mortality from choroidal melanoma. I. Quality of published reports, 1966 through 1988. Arch Ophthalmol. 1992;110(2):239–44.

    Article  CAS  PubMed  Google Scholar 

  2. Diener-West M, Hawkins BS, Markowitz JA, et al. A review of mortality from choroidal melanoma. II. A meta-analysis of 5-year mortality rates following enucleation, 1966 through 1988. Arch Ophthalmol. 1992;110(2):245–50.

    Article  CAS  PubMed  Google Scholar 

  3. Schachat AP. Management of uveal melanoma: a continuing dilemma. Collaborative Ocular Melanoma Study Group. Cancer. 1994;74(11):3073–5.

    Article  CAS  PubMed  Google Scholar 

  4. Fine SL. No one knows the preferred management for choroidal melanoma. Am J Ophthalmol. 1996;122(1):106–8.

    Article  CAS  PubMed  Google Scholar 

  5. Zimmerman LE, McLean IW, Foster WD. Does enucleation of the eye containing a malignant melanoma prevent or accelerate the dissemination of tumour cells. Br J Ophthalmol. 1978;62(6):420–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Singh AD, Rennie IG, Kivelä T, et al. Zimmerman-McLean-Foster hypothesis: 25 years later. Br J Ophthalmol. 2004;88(7):962–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Melia BM, Abramson DH, Albert DM, et al. Collaborative ocular melanoma study (COMS) randomized trial of I-125 brachytherapy for medium choroidal melanoma. I. Visual acuity after 3 years COMS report no. 16. Ophthalmology. 2001;108(2):348–66.

    Article  CAS  PubMed  Google Scholar 

  8. Hawkins BS. Collaborative ocular melanoma study randomized trial of I-125 brachytherapy. Clin Trials. 2011 Oct;8(5):661–73.

    Article  PubMed  Google Scholar 

  9. Kroll S, Char DH, Quivey J, et al. A comparison of cause-specific melanoma mortality and all-cause mortality in survival analyses after radiation treatment for uveal melanoma. Ophthalmology. 1998;105(11):2035–45.

    Article  CAS  PubMed  Google Scholar 

  10. Kujala E, Mäkitie T, Kivelä T. Very long-term prognosis of patients with malignant uveal melanoma. Invest Ophthalmol Vis Sci. 2003;44(11):4651–9.

    Article  PubMed  Google Scholar 

  11. Moy CS, Albert DM, Diener-West M, et al. Cause-specific mortality coding. Methods in the Collaborative Ocular Melanoma Study. COMS report no. 14. Control Clin Trials. 2001;22(3):248–62.

    Article  CAS  PubMed  Google Scholar 

  12. Diener-West M, Earle JD, Fine SL, et al. The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma, III: initial mortality findings. COMS Report No. 18. Arch Ophthalmol. 2001;119(7):969–82.

    Article  CAS  PubMed  Google Scholar 

  13. COMS Group. The Collaborative Ocular Melanoma Study (COMS) randomized trial of pre-enucleation radiation of large choroidal melanoma II: initial mortality findings. COMS report no. 10. Am J Ophthalmol. 1998;125(6):779–96.

    Article  Google Scholar 

  14. COMS Group. Mortality in patients with small choroidal melanoma. COMS report no. 4. The Collaborative Ocular Melanoma Study Group. Arch Ophthalmol. 1997;115(7):886–93.

    Article  Google Scholar 

  15. Straatsma BR, Diener-West M, Caldwell R, et al. Mortality after deferral of treatment or no treatment for choroidal melanoma. Am J Ophthalmol. 2003;136(1):47–54.

    Article  PubMed  Google Scholar 

  16. Byrne SF, Marsh MJ, Boldt HC, et al. Consistency of observations from echograms made centrally in the Collaborative Ocular Melanoma Study COMS Report No. 13. Ophthalmic Epidemiol. 2002;9(1):11–27.

    Article  PubMed  Google Scholar 

  17. COMS Group. Comparison of clinical, echographic, and histopathological measurements from eyes with medium-sized choroidal melanoma in the collaborative ocular melanoma study: COMS report no. 21. Arch Ophthalmol. 2003;121(8):1163–71.

    Article  Google Scholar 

  18. Boldt HC, Byrne SF, Gilson MM, et al. Baseline echographic characteristics of tumors in eyes of patients enrolled in the Collaborative Ocular Melanoma Study: COMS report no. 29. Ophthalmology. 2008;115(8):1390–7. 7 e1–2.

    Article  PubMed  Google Scholar 

  19. Boldt HC, Melia BM, Liu JC, et al. I-125 brachytherapy for choroidal melanoma photographic and angiographic abnormalities: the Collaborative Ocular Melanoma Study: COMS Report No. 30. Ophthalmology. 2009;116(1):106–15. e1.

    Article  PubMed  PubMed Central  Google Scholar 

  20. COMS Group. Histopathologic characteristics of uveal melanomas in eyes enucleated from the Collaborative Ocular Melanoma Study. COMS report no. 6. Am J Ophthalmol. 1998;125(6):745–66.

    Article  Google Scholar 

  21. COMS Group. Trends in size and treatment of recently diagnosed choroidal melanoma, 1987–1997: findings from patients examined at collaborative ocular melanoma study (COMS) centers: COMS report no. 20. Arch Ophthalmol. 2003;121(8):1156–62.

    Article  Google Scholar 

  22. COMS Group. The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma: V. Twelve-year mortality rates and prognostic factors: COMS report No. 28. Arch Ophthalmol. 2006;124(12):1684–93.

    Article  Google Scholar 

  23. Diener-West M, Reynolds SM, Agugliaro DJ, et al. Development of metastatic disease after enrollment in the COMS trials for treatment of choroidal melanoma: Collaborative Ocular Melanoma Study Group Report No. 26. Arch Ophthalmol. 2005;123(12):1639–43.

    Article  PubMed  Google Scholar 

  24. COMS Group. Incidence of cataract and outcomes after cataract surgery in the first 5 years after iodine 125 brachytherapy in the Collaborative Ocular Melanoma Study: COMS Report No. 27. Ophthalmology. 2007;114(7):1363–71.

    Article  Google Scholar 

  25. COMS Group. Factors predictive of growth and treatment of small choroidal melanoma: COMS Report No. 5. The Collaborative Ocular Melanoma Study Group. Arch Ophthalmol. 1997;115(12):1537–44.

    Article  Google Scholar 

  26. Diener-West M, Earle JD, Fine SL, et al. The COMS randomized trial of iodine 125 brachytherapy for choroidal melanoma, II: characteristics of patients enrolled and not enrolled. COMS Report No. 17. Arch Ophthalmol. 2001;119(7):951–65.

    Article  CAS  PubMed  Google Scholar 

  27. COMS Group. Ten-year follow-up of fellow eyes of patients enrolled in Collaborative Ocular Melanoma Study randomized trials: COMS report no. 22. Ophthalmology. 2004;111(5):966–76.

    Article  Google Scholar 

  28. COMS Group. The Collaborative Ocular Melanoma Study (COMS) randomized trial of pre-enucleation radiation of large choroidal melanoma III: local complications and observations following enucleation COMS report no. 11. Am J Ophthalmol. 1998;126(3):362–72.

    Article  Google Scholar 

  29. Fried DB, Morris DE, Poole C, et al. Systematic review evaluating the timing of thoracic radiation therapy in combined modality therapy for limited-stage small-cell lung cancer. J Clin Oncol. 2004;22(23):4837–45.

    Article  PubMed  Google Scholar 

  30. COMS Group. The Collaborative Ocular Melanoma Study (COMS) randomized trial of pre-enucleation radiation of large choroidal melanoma I: characteristics of patients enrolled and not enrolled. COMS report no. 9. Am J Ophthalmol. 1998;125(6):767–78.

    Article  Google Scholar 

  31. Gilson MM, Diener-West M, Hawkins BS. Comparison of survival among eligible patients not enrolled versus enrolled in the Collaborative Ocular Melanoma Study (COMS) randomized trial of pre-enucleation radiation of large choroidal melanoma. Ophthalmic Epidemiol. 2007;14(4):251–7.

    Article  PubMed  Google Scholar 

  32. COMS Group. Assessment of metastatic disease status at death in 435 patients with large choroidal melanoma in the Collaborative Ocular Melanoma Study (COMS): COMS report no. 15. Arch Ophthalmol. 2001;119(5):670–6.

    Article  Google Scholar 

  33. COMS Group. The Collaborative Ocular Melanoma Study (COMS) randomized trial of pre-enucleation radiation of large choroidal melanoma: IV. Ten-year mortality findings and prognostic factors. COMS report number 24. Am J Ophthalmol. 2004;138(6):936–51.

    Article  Google Scholar 

  34. COMS Group. Quality of life assessment in the collaborative ocular melanoma study: design and methods. COMS-QOLS Report No. 1. COMS Quality of Life Study Group. Ophthalmic Epidemiol. 1999;6(1):5–17.

    Article  Google Scholar 

  35. Melia M, Moy CS, Reynolds SM, et al. Development and validation of disease-specific measures for choroidal melanoma: COMS-QOLS report No. 2. Arch Ophthalmol. 2003;121(7):1010–20.

    Article  PubMed  Google Scholar 

  36. Diener-West M, Reynolds SM, Agugliaro DJ, et al. Screening for metastasis from choroidal melanoma: the Collaborative Ocular Melanoma Study Group Report 23. J Clin Oncol. 2004;22(12):2438–44.

    Article  PubMed  Google Scholar 

  37. Eskelin S, Pyrhonen S, Summanen P, et al. Screening for metastatic malignant melanoma of the uvea revisited. Cancer. 1999;85(5):1151–9.

    Article  CAS  PubMed  Google Scholar 

  38. Eskelin S, Kivela T. Imaging to detect metastases from malignant uveal melanoma. Arch Ophthalmol. 2002;120(5):676.

    PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. University of Alberta, Department of Ophthalmology, Edmonton, AB, Canada

    Ezekiel Weis

  2. University of Calgary, Department of Surgery, Calgary, AB, Canada

    Ezekiel Weis

  3. Ocular Oncology and Ophthalmic Pathology, Helsinki University Hospital, Helsinki, Finland

    Tero T. Kivelä

  4. Department of Ophthalmology, University of Helsinki, Helsinki, Finland

    Tero T. Kivelä

  5. Department of Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA

    Arun D. Singh

Authors
  1. Ezekiel Weis
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  2. Tero T. Kivelä
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  3. Arun D. Singh
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Correspondence to Ezekiel Weis .

Editor information

Editors and Affiliations

  1. University of Oxford, Oxford, UK

    Bertil E. Damato

  2. Cole Eye Institute Cleveland Clinic, Cleveland, OH, USA

    Arun D. Singh

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Weis, E., Kivelä, T.T., Singh, A.D. (2019). Uveal Melanoma: The Collaborative Ocular Melanoma Study. In: Damato, B., Singh, A. (eds) Clinical Ophthalmic Oncology. Springer, Cham. https://doi.org/10.1007/978-3-030-17879-6_17

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  • DOI: https://doi.org/10.1007/978-3-030-17879-6_17

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-17878-9

  • Online ISBN: 978-3-030-17879-6

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