Research Department, Cancer Registry of Norway, Oslo, Norway.
Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
Acta Ophthalmol. 2023 Sep;101(6):696-704. doi: 10.1111/aos.15659. Epub 2023 Mar 16.
The purpose of this study is to explore the frequency of additional primary malignancies in uveal melanoma (UM) patients and cause-specific mortality, to help guide surveillance strategies after UM.
All patients diagnosed with UM at Oslo University Hospital during 1990-2017 were eligible for inclusion. Linkage to the Cancer Registry of Norway obtained information on additional malignancies and cause of death throughout 2019. UM patients were categorized according to timing of additional malignancy (prior/simultaneously or after UM) or no additional cancer, and by UM stage at diagnosis. Age-adjusted mortality rates were presented per 1000 person-years with 95% confidence intervals (CI).
The study population included 960 UM patients: 77% were diagnosed in stage and I/II and 56% were men. Mean age at diagnosis was 63 years. Additional malignancies were observed in 152 patients prior/simultaneous to UM, and in 120 patients >1 year after UM. Overall, mortality per 1000 person-years was 3.5 (95% CI 3.1-3.9) for UM and 3.0 (2.6-3.4) for other causes. Lowest UM mortality [1.3 (0.60-2.1)] was seen in patients with a second malignancy after UM, regardless of stage. Highest UM mortality was seen for UM patients in stage III/IV, both without [16.1 (13.2-19.1)] and with any additional malignancy [16.9 (6.6-27.3)].
Our results support that UM patients frequently have additional malignancies, both before and after UM. Low-UM mortality in patients with a primary malignancy after UM, might indicate less aggressive UM. The cumulative UM mortality flattens about 10 years after diagnosis and annual follow-up of patients for 10 years seems adequate.
本研究旨在探讨葡萄膜黑色素瘤（UM）患者中附加原发性恶性肿瘤的发生频率和死因特异性死亡率，以帮助指导 UM 后的监测策略。
所有在 1990 年至 2017 年期间在奥斯陆大学医院诊断为 UM 的患者均符合纳入标准。与挪威癌症登记处的联系获得了 2019 年期间附加恶性肿瘤和死亡原因的信息。根据附加恶性肿瘤的时间（UM 之前/同时或之后）或无附加癌症以及 UM 诊断时的分期对 UM 患者进行分类。呈现了每 1000 人年的年龄调整死亡率，并附有 95%置信区间（CI）。
研究人群包括 960 名 UM 患者：77%的患者诊断为 I/II 期，56%为男性。诊断时的平均年龄为 63 岁。152 名患者在 UM 之前/同时发生了附加恶性肿瘤，120 名患者在 UM 后 1 年以上发生了附加恶性肿瘤。总体而言，UM 和其他原因的每 1000 人年死亡率分别为 3.5（95%CI 3.1-3.9）和 3.0（2.6-3.4）。UM 后发生第二恶性肿瘤的患者 UM 死亡率最低[1.3（0.60-2.1）]，无论分期如何。III/IV 期 UM 患者的 UM 死亡率最高，无论是否存在任何附加恶性肿瘤，死亡率均为[16.1（13.2-19.1）和 16.9（6.6-27.3）]。
我们的结果支持 UM 患者经常在 UM 之前和之后发生附加原发性恶性肿瘤。UM 后发生原发性恶性肿瘤的患者 UM 死亡率较低，可能表明 UM 侵袭性较低。诊断后 10 年左右，UM 的累积死亡率趋于平稳，对患者进行 10 年的年度随访似乎足够。
