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Cohort studyCanadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2026

International validation of a staging system for ciliary body and choroidal melanomas using estimated tumour volume.

Sacha Nahon-Estève, Jean-Pierre Caujolle, Célia Maschi … Gustav Stålhammar

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OphthalmologyCohort study

New tumour-volume staging predicts uveal melanoma prognosis better than AJCC staging

International validation of a staging system for ciliary body and choroidal melanomas using estimated tumour volume.

Sacha Nahon-Estève … Gustav Stålhammar

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2026

Purpose

To validate a newly proposed anatomic staging system for choroidal and ciliary body melanoma, based on tumour volume estimated from routine clinical measurements, and compare its prognostic performance with the American Joint Committee on Cancer (AJCC) 8th edition classification.

Methods

A total of 5 410 consecutive patients diagnosed with choroidal and/or ciliary body melanoma at 6 European ocular oncology centres.

n = 5 410 consecutive patients

Results

new staging spots more high- and low-risk patients correctly than old system

1.42subdis

New classification

1.22subdis

AJCC 8th edition

More results

In competing risk regression, it produced a higher Wald statistic (761 vs 628) and a subdistribution hazard ratio of 1.42 versus 1.22.

Cox regression for melanoma-related mortality demonstrated higher hazard ratios, peaking at 24 for the new model compared with 13 for the AJCC classification.

More results

Cumulative incidence analyses revealed 15-year metastatic death rates ranging from 7% to 76% with the new system versus 11% to 69% with AJCC, widening the absolute range by 11 percentage points.

“

Conclusion · 1 of 2

This large international validation study demonstrates that the new volume-based classification provides more accurate prognostic stratification for choroidal and ciliary body melanoma.

Conclusion · 2 of 2

Its improved risk discrimination, using readily available clinical measurements, supports its applicability in clinical practice and potential utility for guiding follow-up and resource allocation.

Post

International validation of a staging system for ciliary body and choroidal melanomas using estimated tumour volume.

New tumour-volume staging predicts uveal melanoma prognosis better than AJCC staging

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