AOU Careggi, Department of Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Firenze, Florence, Italy.
Ophthalmology, IRCCS-Fondazione Bietti, Rome, Italy.
JAMA Ophthalmol. 2020 Jun 1;138(6):601-608. doi: 10.1001/jamaophthalmol.2020.0531.
Conjunctival melanoma (CM) is a rare ocular tumor. Estimates of incidence and survival of patients with CM are important to researchers and policy makers.
To estimate incidence and survival of patients with CM in Europe.
DESIGN, SETTING, AND PARTICIPANTS: This population-based cohort study used data from 41 European cancer registries adhering to the RARECAREnet project. All individuals diagnosed as having malignant CM from January 1995 to December 2007 coded according to the International Classification of Diseases for Oncology, Third Edition codes C69.0 (conjunctiva) and 8720-8780 (melanoma) were included. Analysis began March 2019.
Trend estimates for incidence and for 5-year relative survival (the ratio of the measured survival of patients to the expected survival in the general population for the same country, age, sex, and calendar year). Crude, age-standardized, and bayesian incidence rates were calculated. Five-year relative survival was calculated by the Ederer II method with the cohort and period approach.
A total of 724 patients 15 years or older (512 [70.7%] were 55 years or older; 366 [50.6%] were female) were analyzed with an overall crude incidence of CM (per 1 000 000 person/y) of 0.46 (95% CI, 0.42-0.49). Crude incidence was similar in men and women (0.48; 95% CI, 0.44-0.54 and 0.46; 95% CI, 0.41-0.51, respectively) and increased with age. Age-standardized incidence increased over time only in men and was the highest in Norway and the Netherlands (more than 0.70). Only 1 case in 14 years was estimated to occur in Iceland vs about 20 cases per year in large countries such as France and Germany. Percentage of 5-year survival (83.5 overall; 95% CI, 78.6-87.3) was not different between adult and elderly patients but showed large geographical disparities across European regions (range, 66-89) and improved markedly in male patients (from 76 in 1995-1998 to 86 in 2003-2007, with a difference of 10.2 [95% CI, 1.3-19.2]; P < .05) becoming similar to that of women in the last period.
Although these data are only available through 2007 and based on registries not uniformly covering the European population, the study provides the first Europe-wide estimates of the incidence and relative survival of patients with CM using population-based data. Geographical differences in survival indicate room for outcome improvement in Southern, Northern, and Eastern European countries.
结膜黑色素瘤（CM）是一种罕见的眼部肿瘤。研究人员和政策制定者需要了解 CM 患者的发病率和生存率的估计值。
估计欧洲 CM 患者的发病率和生存率。
设计、地点和参与者：本基于人群的队列研究使用了 41 个符合 RARECAREnet 项目的欧洲癌症登记处的数据。1995 年 1 月至 2007 年 12 月期间，根据国际肿瘤疾病分类第三版代码 C69.0（结膜）和 8720-8780（黑色素瘤）诊断为恶性 CM 的所有患者均被纳入研究。分析于 2019 年 3 月开始。
计算发病率的趋势估计值和 5 年相对生存率（患者的测量生存率与同一国家、年龄、性别和日历年的一般人群预期生存率的比值）。计算了粗发病率、年龄标准化发病率和贝叶斯发病率。使用队列和时期方法，通过 Ederer II 方法计算 5 年相对生存率。
共分析了 724 名年龄在 15 岁及以上的患者（512 名[70.7%]为 55 岁及以上；366 名[50.6%]为女性），CM 的总体粗发病率（每 100 万人/年）为 0.46（95%CI，0.42-0.49）。男性和女性的粗发病率相似（0.48；95%CI，0.44-0.54 和 0.46；95%CI，0.41-0.51），且随年龄增长而增加。仅在男性中，年龄标准化发病率随时间增加，在挪威和荷兰最高（超过 0.70）。冰岛每 14 年估计发生 1 例，而法国和德国等大国每年约发生 20 例。所有患者的 5 年生存率（总体为 83.5%；95%CI，78.6-87.3）在成年患者和老年患者之间没有差异，但在欧洲各地区之间存在较大的地域差异（范围为 66-89），且男性患者的生存率明显提高（从 1995-1998 年的 76%提高到 2003-2007 年的 86%，差异为 10.2[95%CI，1.3-19.2]；P<.05），与同期女性患者相似。
尽管这些数据仅截止到 2007 年，且基于的登记处并非统一覆盖整个欧洲人口，但该研究使用基于人群的数据首次提供了欧洲 CM 患者发病率和相对生存率的估计值。生存率的地域差异表明，南欧、北欧和东欧国家有改善预后的空间。
