Posterior uveal melanoma incidence and survival by AJCC tumour size in a 70‐year nationwide cohort

Abstract

Purpose: 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. Methods: Nationwide retrospective cohort study linking data from registrybased 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-periodcohort 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. Results: 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 = À0.01%, À0.26 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). Conclusion: Increasing incidence rate and improved survival rate for uveal melanoma was found concordantly with a decrease in tumour size during a 70year period.

Risk of New Primary Cancer in Patients with Posterior Uveal Melanoma: A National Cohort Study

“…The validity and completeness of our primary cohort of patients with posterior UM was ensured by review of all pathology reports since 1968, available patient charts and cross-linking to the Danish Cancer Registry as previously described [ 15 ]. It also allowed us to evaluate only patients with posterior UM and exclude patients with iris melanoma which represent a different sub-class of melanoma with distinct clinical and epidemiological characteristics [ 27 , 28 , 29 ].…”

“…Several resources were used to identify and validate cases, including review of all eye-pathology reports since 1968, clinical charts, the Danish Cancer Registry (DCR), and the Danish Ocular Oncology Group (DOOG) database. The identification and validation procedure of patients with posterior UM have previously been described in detail [ 15 ]. Every Danish citizen has had a unique 10-digit personal identification (CPR) number since 1968, which allows unambiguous individual-level data cross-linkage [ 16 ].…”

Prognostic Biomarkers in Uveal Melanoma: The Status Quo, Recent Advances and Future Directions

“…The disease is usually unilateral and the majority of UM cases have their epicenter in the choroid (≈90%), while nearly 6% of them are restricted to the ciliary body and 4% to the iris ( Figure 1 ) [ 1 , 3 , 16 ]. The annual incidence in Europe and USA is ≈5 per million population, but worldwide it can range from <1 to >9 per million population per year [ 17 , 18 , 19 , 20 ]. Most patients with UM are diagnosed between 50 and 70 years old [ 18 , 21 ].…”

“…The annual incidence in Europe and USA is ≈5 per million population, but worldwide it can range from <1 to >9 per million population per year [ 17 , 18 , 19 , 20 ]. Most patients with UM are diagnosed between 50 and 70 years old [ 18 , 21 ]. The symptoms that most commonly prompt UM patients for a medical visit are blurred or distorted vision, loss of visual fields, photopsia and changes in the colour or appearance of a new lesion in the iris ( Figure 1 ) [ 9 , 22 ].…”

Is Tissue Still the Issue? The Promise of Liquid Biopsy in Uveal Melanoma

“…Uveal melanoma (UM) is a rare but life-threatening disease. The incidence of UM is mildly increasing, which is primarily due to the increased detection of small tumors [ 1 ]. This coincides with a trend towards non-surgical, eye-sparing therapeutic options, in which no tumor tissue is available [ 2 ], as shown in Figure 1 .…”