Liu Yue Ming, Li Yang, Wei Wen Bin, Xu Xiaolin, Jonas Jost B
Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Capital Medical University, Beijing, China.
Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Science Key Lab, Capital Medical University, Beijing, China.
PLoS One. 2015 Dec 8;10(12):e0144562. doi: 10.1371/journal.pone.0144562. eCollection 2015.
To assess clinical characteristics, treatment and survival of patients with uveal melanoma in China.
The retrospective study included all patients with malignant uveal melanoma who were consecutively examined in the study period from January 2005 and June 2015 in the Beijing Tongren hospital.
The mean age of the 582 patients (295(50.7%) women) was 44.6±12.6 years (range: 5-77 years). The tumors were located most often in the superior temporal region (in 117(21.5%) patients) and least common in the inferior region (in 31(5.7%) patients). In 548(94.2%) patients, the tumors were located in the choroid, in 33(5.7%) patients in the ciliary body, and in one (0.2%) patient in the iris. Treatment included episcleral brachytherapy (415(71.3%) patients), local tumor resection (48(8.2%) patients) and primary enucleation (119(20.4%) patients). In 53 individuals out of the 415 patients with primary brachytherapy, episcleral brachytherapy was followed by enucleation, due to an increasing tumor size or due to uncontrolled neovascular glaucoma. Median follow-up time was of 30 months (range: 1-124 months; mean: 34.8 ± 24.4 months). Overall survival rate at 5 and 10 years was of 92.7% and 85.1%. Younger age (P = 0.017), tumor location in the nasal meridian(P = 0.004), smaller tumor size (P<0.001), hemispheric tumor shape (P = 0.025), histological tumor cell type (spindle-cell type versus epitheloid cell type;P = 0.014), and type of treatment (episcleral brachytherapy versus local tumor resection and versus primary enucleation; P<0.001) were significantly associated with the overall survival in univariate analysis, while in multivariate analysis only smaller tumor size was significantly (P<0.001; RR: 4.75; 95% confidence interval: 2.11,10.7) associated with better overall survival.
In this study on clinical characteristics of uveal melanoma of a larger group of patients from China, the onset age was considerably younger and survival rate better than in studies from Western countries. Tumor size was the most significant factor for survival.
评估中国葡萄膜黑色素瘤患者的临床特征、治疗及生存情况。
这项回顾性研究纳入了2005年1月至2015年6月期间在北京同仁医院连续接受检查的所有恶性葡萄膜黑色素瘤患者。
582例患者（295例（50.7%）为女性）的平均年龄为44.6±12.6岁（范围：5 - 77岁）。肿瘤最常位于颞上区域（117例（21.5%）患者），最不常见于下方区域（31例（5.7%）患者）。548例（94.2%）患者的肿瘤位于脉络膜，33例（5.7%）患者位于睫状体，1例（0.2%）患者位于虹膜。治疗方法包括巩膜近距离放疗（415例（71.3%）患者）、局部肿瘤切除术（48例（8.2%）患者）和一期眼球摘除术（119例（20.4%）患者）。在415例行初次近距离放疗的患者中，有53例因肿瘤大小增加或新生血管性青光眼控制不佳，在巩膜近距离放疗后接受了眼球摘除术。中位随访时间为30个月（范围：1 - 124个月；平均：34.8±24.4个月）。5年和10年的总生存率分别为92.7%和85.1%。单因素分析显示，年龄较小（P = 0.017）、肿瘤位于鼻侧子午线（P = 0.004）、肿瘤较小（P<0.001）、半球形肿瘤形态（P = 0.025）、组织学肿瘤细胞类型（梭形细胞型与上皮样细胞型；P = 0.014）以及治疗类型（巩膜近距离放疗与局部肿瘤切除术及一期眼球摘除术；P<0.001）与总生存显著相关，而多因素分析显示只有肿瘤较小与更好的总生存显著相关（P<0.001；风险比：4.75；95%置信区间：2.11,10.7）。
在这项关于中国一大组葡萄膜黑色素瘤患者临床特征的研究中，发病年龄比西方国家的研究中明显更年轻，生存率更高。肿瘤大小是生存的最显著因素。
