Roelofsen Christine D M, Wierenga Annemijn P A, van Duinen Sjoerd, Verdijk Robert M, Bleeker Jaco, Marinkovic Marina, Luyten Gregorius P M, Jager Martine J
Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands.
Department of Emergency Medicine, Leiden University Medical Center, Leiden, The Netherlands.
Ocul Oncol Pathol. 2021 Mar;7(2):133-141. doi: 10.1159/000509918. Epub 2020 Dec 15.
In order to improve medical care for uveal melanoma (UM) patients, we need to monitor disease and survival to guide our research efforts. We analyzed the data of UM patients who underwent an enucleation at the Leiden University Medical Center over the last five decades and investigated trends in patient and tumor characteristics and survival.
Data were collected from charts and pathology reports from all patients who underwent an enucleation for UM between 1973 and 2019 ( = 1,212), of which 1,066 were primary enucleations; data were analyzed according to five time periods: 1973-1979 ( = 209), 1980-1989 ( = 148), 1990-1999 ( = 174), 2000-2009 ( = 280), and 2010-2019 ( = 401).
Over time, mean patient age at the time of enucleation for UM increased from 54.9 to 64.7 years ( < 0.001), more tumors showed histopathological involvement of the ciliary body ( < 0.001), and were classified in a high TNM/AJCC class ( < 0.001). Overall, the 5- and 10-year UM-related survival rates were 0.68 and 0.59, respectively. Over time, survival showed no change in patients with tumors in AJCC stages I or III, with recently a slightly worse survival in stage II UM ( = 0.02).
Between 1973 and 2019, we found similar rates of UM-related survival following enucleation, although we noticed a strong increase in more unfavorable patient and tumor characteristics over time, such as an older age and larger tumor size. The lack of improvement indicates that more research should take place to develop adjuvant treatments to prevent metastases and efficient treatments once metastases develop.
为改善葡萄膜黑色素瘤（UM）患者的医疗护理，我们需要监测疾病情况和生存率，以指导研究工作。我们分析了过去五十年来在莱顿大学医学中心接受眼球摘除术的UM患者的数据，并调查了患者、肿瘤特征及生存率的变化趋势。
收集了1973年至2019年间所有因UM接受眼球摘除术患者（n = 1212）的病历和病理报告数据，其中1066例为初次眼球摘除术；数据按五个时间段进行分析：1973 - 1979年（n = 209）、1980 - 1989年（n = 148）、1990 - 1999年（n = 174）、2000 - 2009年（n = 280）和2010 - 2019年（n = 401）。
随着时间推移，UM患者眼球摘除时的平均年龄从54.9岁增至64.7岁（P < 0.001），更多肿瘤显示睫状体存在组织病理学受累情况（P < 0.001），且被归类为高TNM/AJCC分级（P < 0.001）。总体而言，UM相关的5年和10年生存率分别为0.68和0.59。随着时间推移，AJCC I期或III期肿瘤患者的生存率未发生变化，近期II期UM患者的生存率略差（P = 0.02）。
1973年至2019年间，我们发现眼球摘除术后UM相关生存率相似，尽管随着时间推移，我们注意到患者和肿瘤特征更趋不利的情况显著增加，如年龄增大和肿瘤尺寸增大。缺乏改善表明应开展更多研究，以开发辅助治疗方法来预防转移，并在转移发生后进行有效治疗。
