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S Al-Khalifa, J Burnier, AL Caissie, SA Callejo, J-CA Marshall, MN Burnier; Second Non-Ocular Primary Tumors in Uveal Melanoma Patients . Invest. Ophthalmol. Vis. Sci. 2002;43(13):1146.
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Purpose:Uveal melanoma is the most common intra-ocular tumor in adults. With an incidence of 7 in 1 million people, this rare malignancy represents 5.2% of all human melanoma cases. All cancer patients have an increased risk of developing a second primary tumor and previous studies, using North American data, have reported that between 8-13% of uveal melanoma patients develop other primary tumors. The objective of this study is to determine the incidence of second non-ocular primary tumors in uveal melanoma patients and compare the incidence of such tumors in melanoma patients with the incidence of the same tumors in the general population. Methods:Data of 110 uveal melanoma patients, dating back to 1990, was obtained from the Royal Victoria Cancer Registry and the Henry C. Witelson Eye Pathology Laboratory, Montreal, Canada. The number of uveal melanoma patients with second tumors, unrelated to metastasis, was recorded as well as the type of second non-ocular primary tumor. General population incidence rates (per 100 000) of the various types of tumors in patients between the ages of 60 and 64 were obtained from Health Canada/The Canadian Cancer Society. Results:The mean age of the uveal melanoma patients was 61.5. Thirteen out of 110 (11.8%) uveal melanoma patients, 8 of 58 male (M) and 5 of 52 female (F), had second non-ocular tumors. The type of second primary tumors included prostate (4 cases), colon (3 cases, 2 M and 1 F), cervix (1 case), stomach (1 case, M), lung (2 cases, 1 M and 1F), skin (1 case, F), and breast cancer (1 case, F). The general population incidence rates per 100 000 individuals are: prostate cancer 333.8, colorectal cancer 180.6 M and 124.5 F, cervical cancer 18.6, stomach cancer 42.2 M, lung cancer 327.4 M and 126.4 F, skin melanoma 15.5 F and breast cancer 266.9 F. Conclusion:In this Canadian based population, uveal melanoma patients showed a high incidence of second non-ocular primary tumors. The incidence of these second tumors, unrelated to metastasis, is particularly important due to the rarity of uveal melanoma itself. Twelve of the 13 second non-ocular primary tumors were of epithelial origin while the only non-epithelial second tumor was a cutaneous melanoma. Further studies, investigating common biological mechanisms of melanoma and epithelial tumors, should be performed.
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