Mahendraraj Krishnaraj, Shrestha Sneha, Lau Christine Sm, Chamberlain Ronald S
Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA.
Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA; Saint George's University School of Medicine, Grenada, West Indies.
Clin Ophthalmol. 2017 Jan 5;11:153-160. doi: 10.2147/OPTH.S120530. eCollection 2017.
Ocular melanoma (OM) comprises <5% of all melanomas. Uveal melanoma (UM) is the most common subtype of OM, while conjunctival melanoma (CM) is rare and differs significantly from UM. The purpose of this study is to evaluate a large cohort of OM patients to differentiate demographic, pathologic, and clinical factors between these two neoplasms, which may affect treatment and outcomes.
The Surveillance, Epidemiology, and End Results database (1973-2012) was used to extract demographic and clinical data on 8,165 OM patients (92.1% UM and 7.9% CM).
Both CM and UM were most prevalent among Caucasian males in the seventh decade of life. UM patients presented more often with localized disease (90.9% vs 81.2, <0.01). Surgery (42.8%), radiation (43.0%), or combined surgery and radiation (7.0%) were used in the treatment of UM, while CM was treated almost exclusively with surgery (88.7%). Mean overall survival was longer (15.4 vs 14.6 years; <0.01) and mortality rates were lower in patients (38.8% vs 46.1%; <0.01) with CM.
Despite presenting with more advanced disease than UM, CM is associated with an increased overall survival. Surgery is the primary therapy for CM, whereas radiotherapy is the primary therapy for UM and is associated with prolonged survival.
眼黑色素瘤（OM）占所有黑色素瘤的比例不到5%。葡萄膜黑色素瘤（UM）是OM最常见的亚型，而结膜黑色素瘤（CM）较为罕见，且与UM有显著差异。本研究的目的是评估一大群OM患者，以区分这两种肿瘤之间的人口统计学、病理学和临床因素，这些因素可能会影响治疗和预后。
利用监测、流行病学和最终结果数据库（1973 - 2012年）提取8165例OM患者（92.1%为UM，7.9%为CM）的人口统计学和临床数据。
CM和UM在70岁的白种男性中最为常见。UM患者更多表现为局限性疾病（90.9%对81.2%，<0.01）。UM的治疗采用手术（42.8%）、放疗（43.0%）或手术联合放疗（7.0%），而CM几乎仅采用手术治疗（88.7%）。CM患者的平均总生存期更长（15.4年对14.6年；<0.01），死亡率更低（38.8%对46.1%；<0.01）。
尽管CM比UM表现出更晚期的疾病，但CM与总生存期增加相关。手术是CM的主要治疗方法，而放疗是UM的主要治疗方法且与生存期延长相关。
