美国2000年至2018年眼部黑色素瘤患者基于发病率的死亡率的全国性趋势
Nation-Wide Trends in Incidence-Based Mortality of Patients with Ocular Melanoma in USA: 2000 to 2018.
作者信息
Valasapalli Srijan, Guddati Achuta Kumar
机构信息
Department of Medicine, Carle Foundation Hospital, Urbana, IL, 61801, USA.
Division of Hematology/Oncology, Georgia Cancer Center, Augusta University, Augusta, GA, 30909, USA.
出版信息
Int J Gen Med. 2021 Aug 5;14:4171-4176. doi: 10.2147/IJGM.S299144. eCollection 2021.
BACKGROUND
Ocular and orbit melanoma is a rare subtype of melanoma for which outcomes have not been adequately reported. We have analyzed the incidence-based mortality trends of ocular and orbit melanoma over 15 years in USA. Most ocular melanomas originate from the uvea and, to a lesser extent, from the conjunctiva. Primary orbital melanoma is exceedingly rare.
METHODS
The Surveillance, Epidemiology, and End Results (SEER) database was queried to find the incidence-based mortality for all patients diagnosed with ocular and orbit melanoma for the years 2000 to 2018. Results were grouped by gender and race (Caucasian/White, African American/Black, American Indian/Alaskan Native, and Asian/Pacific Islanders). A paired -test was used to determine the statistically significant difference between various subgroups (p < 0.05).
RESULTS
Incidence-based mortality has been the highest in Caucasian/White patients from 2000 to 2018, followed by African American/Black and Asian/Pacific Islander patients. American Indian/Alaskan native patients appear to have the least mortality. There was a statistically significant difference (p<0.05) in mortality between Caucasian/White patients from 2000 to 2018, and African American/Black and Asian/Pacific Islander patients. The sample size for African American/Black and American Indian/Alaskan native patients was too low to discern a meaningful trend in mortality. Overall, it appears that Caucasian males and females have a far higher and worsening incidence-based mortality compared to other races.
CONCLUSION
Ocular melanoma and orbit melanoma are rare entities that are predominantly seen in Caucasian/White patients. This study shows that incidence-based mortality has been worsening for these patients in the past two decades. These entities have a poor prognosis and have not been studied extensively in immunotherapy trials. There is a need for new clinical trials to help improve mortality rates.
背景
眼及眼眶黑色素瘤是黑色素瘤的一种罕见亚型,其预后情况尚未得到充分报道。我们分析了美国15年间基于发病率的眼及眼眶黑色素瘤死亡率趋势。大多数眼黑色素瘤起源于葡萄膜,少数起源于结膜。原发性眼眶黑色素瘤极为罕见。
方法
查询监测、流行病学和最终结果(SEER)数据库,以获取2000年至2018年所有诊断为眼及眼眶黑色素瘤患者的基于发病率的死亡率。结果按性别和种族(白人/高加索人、非裔美国人/黑人、美洲印第安人/阿拉斯加原住民以及亚裔/太平洋岛民)进行分组。采用配对t检验确定各亚组之间的统计学显著差异(p<0.05)。
结果
2000年至2018年,白人/高加索患者的基于发病率的死亡率最高,其次是非裔美国人/黑人和亚裔/太平洋岛民患者。美洲印第安人/阿拉斯加原住民患者的死亡率似乎最低。2000年至2018年,白人/高加索患者与非裔美国人/黑人和亚裔/太平洋岛民患者之间的死亡率存在统计学显著差异(p<0.05)。非裔美国人/黑人和美洲印第安人/阿拉斯加原住民患者的样本量过低,无法辨别出有意义的死亡率趋势。总体而言,与其他种族相比,白人男性和女性的基于发病率的死亡率要高得多且呈恶化趋势。
结论
眼黑色素瘤和眼眶黑色素瘤是罕见疾病,主要见于白人/高加索患者。本研究表明在过去二十年中,这些患者基于发病率的死亡率一直在恶化。这些疾病预后较差,在免疫治疗试验中尚未得到广泛研究。需要开展新的临床试验以帮助提高死亡率。