Ocular melanoma-when you have seen one, you have not seen them all: a clinical outcome study from the Surveillance, Epidemiology and End Results (SEER) database (1973–2012)

Abstract

BackgroundOcular melanoma (OM) comprises <5% of all melanomas. Uveal melanoma (UM) is the most common subtype of OM, while conjunctival melanoma (CM) is rare and differs significantly from UM. The purpose of this study is to evaluate a large cohort of OM patients to differentiate demographic, pathologic, and clinical factors between these two neoplasms, which may affect treatment and outcomes.MethodsThe Surveillance, Epidemiology, and End Results database (1973–2012) was used to extract demographic and clinical data on 8,165 OM patients (92.1% UM and 7.9% CM).ResultsBoth CM and UM were most prevalent among Caucasian males in the seventh decade of life. UM patients presented more often with localized disease (90.9% vs 81.2, P<0.01). Surgery (42.8%), radiation (43.0%), or combined surgery and radiation (7.0%) were used in the treatment of UM, while CM was treated almost exclusively with surgery (88.7%). Mean overall survival was longer (15.4 vs 14.6 years; P<0.01) and mortality rates were lower in patients (38.8% vs 46.1%; P<0.01) with CM.ConclusionDespite presenting with more advanced disease than UM, CM is associated with an increased overall survival. Surgery is the primary therapy for CM, whereas radiotherapy is the primary therapy for UM and is associated with prolonged survival.

Clinical features and survival outcomes of ocular melanoma in a multi-ethnic Asian cohort

“…In Chinese (n = 171) and Korean (n = 33) patients, the 5-year metastasis-free survival rate approximates 80% 11 , 14 and are higher survival rates than European (n = 5,788) 21 and US cohorts (n = 1,003) 22 which reported 5-year survival rates bordering at or less than 70% 11 . However, these lower survival rates were based on older data and more recent studies in the US 23 and Scotland (n = 218) 24 report slightly higher 5-year cancer-specific survival ranging from 70 to 80%. On the contrary for CM, poorer survival outcomes have been reported in Asians compared to Caucasians, due in part to the advanced stages at presentation and poor melanoma awareness in Asia 15 , 17 .…”

“…In Chinese (n = 171) and Korean (n = 33) patients, the 5-year metastasis-free survival rate approximates 80% 11,14 and are higher survival rates than European (n = 5,788) 21 and US cohorts (n = 1,003) 22 which reported 5-year survival rates bordering at or less than 70% 11 . However, these lower survival rates were based on older data and more recent studies in the US 23 and Scotland (n = 218) 24 report…”

<p>Impact of Marital Status on Survival in Patients with Ocular and Periocular Malignancies: A Retrospective Analysis of 3159 Patients from the SEER Database</p>

“…Similar to previous studies, mortality risk also significantly differed by the malignancy's site of origin within the eye and orbit. 13 Differences found with regard to chemotherapy and radiation treatment, although important statistically in adjustment, have unclear clinical significance as subgroups were classified as "yes" or "no/ unknown". Individuals with unknown status may have received treatment confounding this finding, a known limitation of the SEER dataset.…”

Prognostic Factors Five Years After Enucleation for Uveal Melanoma

“…The mean annual age-adjusted incidence is 5.1 per million in the United States. 2 It is estimated that 6700 to 7100 new patients are diagnosed worldwide annually and that there are 87,000 to 106,000 survivors, many of whom are under surveillance for the development of overt metastases. 3 UM metastasizes hematogenously, with a predilection for the liver.…”