PURPOSE: We aimed to model and compare mortality rates for uveal melanoma (UM) and conjunctival melanoma (CM) by adjusting for differences in tumour size and local recurrence. METHODS: Population-based mortality data for 240 and 85 patients with primary UM and CM and 91 and 23 patients with disseminated UM and CM, respectively, were compared with cumulative incidence analysis. Cox proportional hazards multivariate regression with time-dependent variables was used to adjust for differences in tumour diameter, thickness and recurrence rates. RESULTS: The 10-year cumulative incidences of metastatic death from UM and CM were 39% (95% confidence interval [CI] 33-45) and 32% (95% CI 21-44), respectively. After adjusting for tumour size, risk of death from CM was higher than from UM (hazard ratio [HR] 1.9; p = 0.039). Additional adjustment for more frequent local recurrence of CM diminished the difference (HR 1.5; p = 0.25). Survival periods after systemic metastasis of UM and CM were comparable (median 8 months). CONCLUSIONS: Clinical observations show longer survival after primary CM than after primary UM. This reflects the smaller average size of CM. However, a primary CM of a given size is more deadly than a UM of equivalent size because primary CM tends to recur after treatment and, possibly, because additional lymphatic dissemination occurs with CM.
PURPOSE: We aimed to model and compare mortality rates for uveal melanoma (UM) and conjunctival melanoma (CM) by adjusting for differences in tumour size and local recurrence. METHODS: Population-based mortality data for 240 and 85 patients with primary UM and CM and 91 and 23 patients with disseminated UM and CM, respectively, were compared with cumulative incidence analysis. Cox proportional hazards multivariate regression with time-dependent variables was used to adjust for differences in tumour diameter, thickness and recurrence rates. RESULTS: The 10-year cumulative incidences of metastatic death from UM and CM were 39% (95% confidence interval [CI] 33-45) and 32% (95% CI 21-44), respectively. After adjusting for tumour size, risk of death from CM was higher than from UM (hazard ratio [HR] 1.9; p = 0.039). Additional adjustment for more frequent local recurrence of CM diminished the difference (HR 1.5; p = 0.25). Survival periods after systemic metastasis of UM and CM were comparable (median 8 months). CONCLUSIONS: Clinical observations show longer survival after primary CM than after primary UM. This reflects the smaller average size of CM. However, a primary CM of a given size is more deadly than a UM of equivalent size because primary CM tends to recur after treatment and, possibly, because additional lymphatic dissemination occurs with CM.
Authors: Katarina Cisarova; Marc Folcher; Ikram El Zaoui; Rosanna Pescini-Gobert; Virginie G Peter; Beryl Royer-Bertrand; Leonidas Zografos; Ann Schalenbourg; Michael Nicolas; Donata Rimoldi; Serge Leyvraz; Nicolò Riggi; Alexandre P Moulin; Carlo Rivolta Journal: PLoS Genet Date: 2020-12-31 Impact factor: 5.917
Authors: Natasha M van Poppelen; Jolique A van Ipenburg; Quincy van den Bosch; Jolanda Vaarwater; Tom Brands; Bert Eussen; Frank Magielsen; Hendrikus J Dubbink; Dion Paridaens; Erwin Brosens; Nicole Naus; Annelies de Klein; Emine Kiliç; Robert M Verdijk Journal: Int J Mol Sci Date: 2021-05-28 Impact factor: 5.923