葡萄膜黑色素瘤：发病趋势、治疗方法和生存率。

Uveal melanoma: trends in incidence, treatment, and survival.

机构信息

Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.

出版信息

Ophthalmology. 2011 Sep;118(9):1881-5. doi: 10.1016/j.ophtha.2011.01.040. Epub 2011 Jun 24.

DOI:10.1016/j.ophtha.2011.01.040

PMID:21704381

Abstract

PURPOSE

To determine trends in incidence, treatment, and survival with primary uveal melanoma in the United States over a 36-year period from 1973 to 2008.

DESIGN

Systematic review of existing databases.

PARTICIPANTS

A total of 4070 patients with primary uveal melanoma (International Classification of Disease for Oncology [ICD-O-2] codes C69.3 [choroid], C69.4 [ciliary body and iris], and C69.2 [retina]) derived from the Surveillance, Epidemiology, and End Results (SEER) program database in the United States from 1973 to 2008.

METHODS

The significance of trends in age-adjusted incidence, treatment, and 5-year relative survival rates were determined using chi-square testing and 95% confidence intervals (CIs).

MAIN OUTCOME MEASURES

Age-adjusted incidence, form of treatment (surgery, radiation, or both), and 5-year relative survival rates.

RESULTS

There were 4070 cases of uveal melanoma representing 3.1% of all recorded cases of melanoma. The majority of cases (98.3%) were reported by hospital inpatient/outpatient clinics. Histopathologic confirmation was available in 2804 cases (72.1% for all years). The mean age-adjusted incidence of uveal melanoma in the United States was 5.1 per million (95% CI, 4.8-5.3). The majority of cases (97.8%) occurred in the white population. There was a statistically significant variation of age-adjusted incidence between sexes (male = 5.8, 95% CI, 5.5-6.2; and female = 4.4, 95% CI, 4.2-4.7). A decreasing trend was observed in patients treated with surgery alone (93.8% for 1973-1975 vs. 28.3% for 2006-2008), whereas a corresponding increase was seen in those treated with radiation (1.8% for 1973-1975 vs. 62.5% for 2006-2008). No change in the 5-year relative survival rate (81.6%) was observed from 1973 to 2008.

CONCLUSIONS

The age-adjusted incidence of uveal melanoma (5.1 per million) has remained unchanged from 1973 to 2008. Despite a shift toward more conservative treatments, survival has not improved during this time period.

摘要

目的

在 1973 年至 2008 年的 36 年间，通过对美国现有的数据库进行系统性回顾，确定原发性葡萄膜黑色素瘤的发病率、治疗和生存趋势。

设计

对现有数据库的系统回顾。

参与者

美国监测、流行病学和最终结果（SEER）计划数据库中，1973 年至 2008 年共 4070 例原发性葡萄膜黑色素瘤患者（国际肿瘤疾病分类 [ICD-O-2] 代码 C69.3[脉络膜]、C69.4[睫状体和虹膜]和 C69.2[视网膜]）。

方法

使用卡方检验和 95%置信区间（CI）确定年龄调整发病率、治疗和 5 年相对生存率的趋势的显著性。

主要观察指标

年龄调整发病率、治疗形式（手术、放疗或两者结合）和 5 年相对生存率。

结果

共 4070 例葡萄膜黑色素瘤病例，占所有黑色素瘤病例的 3.1%。大多数病例（98.3%）是由医院门诊/住院诊所报告的。2804 例（所有年份的 72.1%）有组织病理学证实。美国葡萄膜黑色素瘤的平均年龄调整发病率为 5.1/100 万（95%CI，5.8-5.3）。大多数病例（97.8%）发生在白人中。男性和女性之间的年龄调整发病率存在统计学显著差异（男性=5.8，95%CI，5.5-6.2；女性=4.4，95%CI，4.2-4.7）。仅接受手术治疗的患者比例呈下降趋势（1973-1975 年为 93.8%，2006-2008 年为 28.3%），而接受放疗的患者比例则相应增加（1973-1975 年为 1.8%，2006-2008 年为 62.5%）。1973 年至 2008 年间，5 年相对生存率（81.6%）无变化。