Xu Yufeng, Lou Lixia, Wang Yijie, Miao Qi, Jin Kai, Chen Menglu, Ye Juan
Department of Ophthalmology, The Second Affiliated Hospital of Zhejiang University, College of Medicine, 88 Jiefang Road, Hangzhou, Zhejiang 310009, China.
J Ophthalmol. 2020 Feb 19;2020:3614039. doi: 10.1155/2020/3614039. eCollection 2020.
Uveal melanoma is the most common intraocular malignancy, and the American Joint Committee on Cancer (AJCC) changed its staging methodology from 2010, incorporating notable changes into the T-staging. There were few literatures evaluating the epidemiological trend and risk factors of survival in multicenter longitudinal studies regarding the new staging system.
We performed population-based cohort analyses using the Surveillance, Epidemiology, and End Results (SEER) database to identify patients with primary uveal melanoma from 2010 to 2015. Patients and potential prognosis indicators were extracted from SEER 18. Incidence rates, incidence rates ratios (IRR), annual percent changes (APC) in rate, hazard ratios (HR), 5-year accumulative overall survival (OS), and disease-specific survival (DSS) were calculated.
A total of 2631 patients for incidence analysis and 1142 patients for survival analysis were retrieved. The overall incidence of uveal melanoma was 4.637 per million (95% confidence interval (CI), 4.458-4.821), which was significantly elevated by average APC of 4.215% ( = 0.03). Females had significantly lower incidence (4.076 per million, IRR, 0.768, 95% CI, 0.710-0.832) with noticeable differences among age, race, origin, and laterality in sex-stratified analyses as well. Survival analyses revealed 5-year accumulative OS and DSS for patients with uveal melanoma of 61.8% and 66.5%, respectively. Age, AJCC stage, and radiation therapy were found to be consistent predictors in both univariate and multivariate analysis models.
Incidence of uveal melanoma increased by significant APC and varied between genders. Determinants of survival included age at diagnosis, AJCC stage, and radiation therapy.
葡萄膜黑色素瘤是最常见的眼内恶性肿瘤,美国癌症联合委员会(AJCC)自2010年起更改了其分期方法,在T分期中纳入了显著变化。在多中心纵向研究中,针对新分期系统评估生存的流行病学趋势和危险因素的文献较少。
我们使用监测、流行病学和最终结果(SEER)数据库进行基于人群的队列分析,以识别2010年至2015年的原发性葡萄膜黑色素瘤患者。从SEER 18中提取患者和潜在的预后指标。计算发病率、发病率比(IRR)、发病率的年度百分比变化(APC)、风险比(HR)、5年累积总生存率(OS)和疾病特异性生存率(DSS)。
共检索到2631例患者用于发病率分析,1142例患者用于生存分析。葡萄膜黑色素瘤的总体发病率为每百万4.637例(95%置信区间(CI),4.458 - 4.821),平均APC为4.215%使其显著升高( = 0.03)。女性发病率显著较低(每百万4.076例,IRR,0.768,95% CI,0.710 - 0.832),在按性别分层分析中,年龄、种族、来源和患侧性方面也存在明显差异。生存分析显示,葡萄膜黑色素瘤患者的5年累积OS和DSS分别为61.8%和66.5%。在单变量和多变量分析模型中,年龄、AJCC分期和放疗均为一致的预测因素。
葡萄膜黑色素瘤发病率因显著的APC而增加,且存在性别差异。生存的决定因素包括诊断时的年龄、AJCC分期和放疗。