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Mortality in patients with small choroidal melanoma . COMS report no . 4 . The Collaborative Ocular Melanoma Study Group . OBJECTIVE To describe the clinical characteristics and survival experience of a prospectively followed up group of patients with small choroidal melanoma . METHODS The Collaborative Ocular Melanoma Study ( COMS ) is a set of clinical trials designed to compare the role of radiotherapy and enucleation in the treatment of medium and large-size choroidal melanoma . From December 1986 to August 1989 , patients with small choroidal melanoma , not large enough to be eligible for the COMS clinical trials , were offered participation in a nonrandomized prospective follow-up study . Small choroidal melanomas were defined as 1.0 to 3.0 mm in apical height and at least 5.0 mm in basal diameter . A total of 204 patients were enrolled in the study . Patients were followed up annually through August 1989 . Two additional assessments of treatment status and mortality were conducted in 1993-1994 and 1995-1996 . The median length of follow-up was 92 months . Eight percent of patients were treated at the time of study enrollment and an additional 33 % were treated during follow-up . RESULTS Twenty-seven patients have died ; 6 deaths were reported by the clinical center as due to metastatic melanoma . The Kaplan-Meier estimate of 5-year all-cause mortality was 6.0 % ( 95 % confidence interval , 2.7 % -9.3 % ) and 8-year all-cause mortality was 14.9 % ( 95 % confidence interval , 9.6 % -20.2 % ) . CONCLUSIONS Otherwise healthy patients , average age of 60 years , without a previous diagnosis of malignant disease who have small choroidal lesions judged to be melanoma have a low risk of dying within 5 years .
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radiotherapy
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enucleation
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Outcome_Mortality
Mortality
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mortality
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median length
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Outcome_Mortality
died
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Outcome_Mortality
deaths
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Outcome_Physical
metastatic melanoma
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mortality
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mortality
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Outcome_Physical
choroidal lesions