Department of Ophthalmology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Department of Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
Acta Ophthalmol. 2021 Dec;99(8):e1474-e1482. doi: 10.1111/aos.14847. Epub 2021 Mar 18.
While early treatment of posterior uveal melanoma can save the eye, the effect of early treatment on survival remains unknown. Therefore, we aimed to determine whether the tumour size at diagnosis has changed over time, and if this has affected survival rates of patients with posterior uveal melanoma in Denmark.
Nationwide retrospective cohort study linking data from registry-based resources to data from clinical charts and pathology records. Including all Danish patients diagnosed with posterior uveal melanoma from 1943 to 2017. Incidence rates were estimated as annual percentage change (APC) overall and by American Joint Committee on Cancer (AJCC) tumour sizes. The age-period-cohort model was applied to estimate the relative risk of calendar period. The cox proportional hazards model, relative survival Kaplan-Meier curves and cumulative incidence curves were applied to estimate the effect of calendar period on survival.
An overall increase in incidence rate of uveal melanoma was found (APC = 0.25%, 0.08-0.42; 95% CI). This was due to increasing incidence rate of AJCC T1 + T2 tumours (APC = 0.97%, 0.57-1.37; 95% CI), whereas no increase in incidence rates of AJCC T3 + T4 tumours was found (APC = -0.01%, -0.26 to 0.25; 95% CI). The disease-specific survival improved with calendar period for all tumour sizes (HR = 0.988; 0.984-0.993; 95% CI).
Increasing incidence rate and improved survival rate for uveal melanoma was found concordantly with a decrease in tumour size during a 70-year period.
虽然早期治疗脉络膜黑色素瘤可以挽救眼睛，但早期治疗对生存率的影响尚不清楚。因此，我们旨在确定诊断时肿瘤大小是否随时间发生变化，以及这是否影响丹麦脉络膜黑色素瘤患者的生存率。
这是一项全国性回顾性队列研究，将来自登记处资源的数据与临床图表和病理记录的数据进行了关联。纳入了 1943 年至 2017 年期间所有在丹麦被诊断为脉络膜黑色素瘤的患者。通过美国癌症联合委员会（AJCC）肿瘤大小计算，总体和肿瘤大小的年度百分比变化（APC）估计了发病率。应用年龄-时期-队列模型估计了日历时期的相对风险。应用 Cox 比例风险模型、生存 Kaplan-Meier 曲线和累积发病率曲线估计了日历时期对生存的影响。
发现脉络膜黑色素瘤的发病率总体呈上升趋势（APC=0.25%，0.08-0.42；95%CI）。这是由于 AJCC T1+T2 肿瘤的发病率上升（APC=0.97%，0.57-1.37；95%CI），而 AJCC T3+T4 肿瘤的发病率没有上升（APC=-0.01%，-0.26 至 0.25；95%CI）。所有肿瘤大小的疾病特异性生存率均随日历时期而提高（HR=0.988；0.984-0.993；95%CI）。
在 70 年期间，脉络膜黑色素瘤的发病率呈上升趋势，生存率也随之提高，同时肿瘤大小呈下降趋势。
