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M. Hendrix; Second Primary Malignancies in Patients with Conjunctival Melanoma . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2430.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:Second primary malignancies following both cutaneous melanoma and uveal melanoma have been described in the literature. However, no evaluation of second primary malignancies following conjunctival melanoma has been done. The purpose of this study is to investigate second primary malignancies in patients with conjunctival melanoma. Methods: Analyses of the SEER 11 database of the National Cancer Institute were performed for the years 1972 through 1999. All patients with a diagnosis of conjunctival melanoma with or without a second primary malignancy were identified. Survival time, sex and age at diagnosis were used to determine the expected number of malignancies based on the person-years method. The observed number of each type of second primary malignancy was compared with the expected number based on age-adjusted incidences provided by the SEER Cancer Statistics Review, 1973-1999. Relative risk was calculated based on the observed/expected ratio. Results: A total of 208 patients with conjunctival melanoma were identified. 117 (56%) were male and 91 (44%) were female. The mean age at diagnosis was 62.3 years. 53 second primary malignancies were found in 39 (18.8%) patients, 22 (56%) male and 17 (44%) female. The mean interval between the diagnoses of conjunctival melanoma and a second primary malignancy was 35.5 months. Of these 53 second primary malignancies, 21 (39.6%) were non-metastatic melanomas. Of these 21 melanomas, 15 were cutaneous and 7 were ocular. The primary sites for the non-melanoma second primary malignancies were Prostate 7 (13.2%), Lung 7 (13.2%), Colon 5 (9.4%), Lymphoma 2 (3.8%), Bladder 2 (3.8%), Breast 1 (1.9%), Cervix 1 (1.9%), Chronic Lymphocytic Leukemia 1 (1.9%), Multiple Myeloma 1 (1.9%), Ocular 1 (1.9%), Stomach 1 (1.9%), Thyroid 1 (1.9%), Uterine 1 (1.9%). Relative risk (RR) for developing a second primary malignancy reached significance only for cutaneous melanoma (RR=80.75, p<0.001), lung carcinoma (RR=4.93, p<0.05) and prostate carcinoma (RR=5.58, p<0.05). Conclusions: Data from the SEER 11 database of the National Cancer Institute reveals that patients with conjunctival melanoma have an increased risk for second primary cutaneous melanomas and prostate cancer. An 80-fold increased risk of second primary cutaneous melanomas, a 4.9-fold increased risk for lung carcinoma and a 5.5-fold increased risk of second primary prostate cancer were found. The relative risk found for second primary melanomas was much higher than that found in prior studies for patients with cutaneous melanoma (relative risks between 20 and 38.5). Further population-based studies are needed to confirm these associations.
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