Park San Jun, Oh Chang-Mo, Yeon Bora, Cho Hyunsoon, Park Kyu Hyung
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Cancer Registration and Statistic Branch, Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Republic of Korea.
Invest Ophthalmol Vis Sci. 2017 Mar 1;58(3):1909-1915. doi: 10.1167/iovs.16-20077.
The purpose of this study was to determine the survival rate of patients with uveal melanoma and sex disparity in this rate in South Korea.
We extracted incident uveal melanoma patients using the Korea Central Cancer Registry (KCCR) database, which covered the entire population from 1999 to 2012 in South Korea. We estimated all-cause survival probabilities and cancer-specific survival probabilities of patients with uveal melanoma and compared these probabilities between subgroups (sex, tumor site, age at diagnosis, etc.) using Kaplan-Meier methods and log-rank tests. We fitted the Cox-proportional hazards models for all-cause death and cancer death to determine sex disparities in survival.
A total of 344 uveal melanoma patients (175 women, 51%) were ascertained. They comprised 283 patients with choroidal melanoma (82%) and 61 patients with ciliary body/iris melanoma (18%). The observed 5-year survival probability from all-cause death was 75% (95% confidence interval [CI]: 69%-79%); women with uveal melanoma showed higher survival probability (83% [95% CI: 76%-89%]) compared with men (66% [95% CI: 58%-73%], P < 0.01). After adjusting for age, year of diagnosis, tumor sites, and diagnostic verification method, the hazards for all-cause death and cancer death in women with uveal melanoma were lower than those in men (hazards ratio for cancer death = 0.50 [95% CI: 0.30-0.81]; hazards ratio for all-cause death = 0.39 [95% CI: 0.25-0.61]).
Women with uveal melanoma have better survival probabilities relative to men with uveal melanoma. Our findings show a comprehensive picture of survival probability in uveal melanoma cancer patients in Korea, which requires further investigation of mechanism of the sex disparity in uveal melanoma.
本研究旨在确定韩国葡萄膜黑色素瘤患者的生存率以及该生存率中的性别差异。
我们利用韩国中央癌症登记处（KCCR）数据库提取了初发葡萄膜黑色素瘤患者，该数据库涵盖了1999年至2012年韩国的全部人口。我们估计了葡萄膜黑色素瘤患者的全因生存概率和癌症特异性生存概率，并使用Kaplan-Meier方法和对数秩检验比较了亚组（性别、肿瘤部位、诊断时年龄等）之间的这些概率。我们对全因死亡和癌症死亡拟合了Cox比例风险模型，以确定生存中的性别差异。
共确定了344例葡萄膜黑色素瘤患者（175例女性，占51%）。其中包括283例脉络膜黑色素瘤患者（82%）和61例睫状体/虹膜黑色素瘤患者（18%）。观察到的全因死亡5年生存概率为75%（95%置信区间[CI]：69%-79%）；葡萄膜黑色素瘤女性患者的生存概率（83%[95%CI：76%-89%]）高于男性（66%[95%CI：58%-73%]，P<0.01）。在调整年龄、诊断年份、肿瘤部位和诊断验证方法后，葡萄膜黑色素瘤女性患者的全因死亡和癌症死亡风险低于男性（癌症死亡风险比=0.50[95%CI：0.30-0.81]；全因死亡风险比=0.39[95%CI：0.25-0.61]）。
与葡萄膜黑色素瘤男性患者相比，女性患者具有更好的生存概率。我们的研究结果展示了韩国葡萄膜黑色素瘤癌症患者生存概率的全貌，这需要对葡萄膜黑色素瘤性别差异的机制进行进一步研究。
