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Ofira Zloto, Jacob Pe'er, Shahar Frenkel; Gender Differences in Clinical Presentation and Prognosis of Uveal Melanoma. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3265.
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The purpose of this study was to examine the clinical differences in development and manifestation of uveal melanoma (UM) between men and women.
The study included 723 patients (325 men and 398 women) with UM, who were treated between 1988 and 2010 at a single center (Hadassah-Hebrew University Medical Center, Jerusalem, Israel). Men and women were compared regarding differences in annual incidence, age at diagnosis, size and intraocular location of the tumor, symptoms leading to diagnosis, recurrence, metastases development and mortality. Statistical analysis included: student t-test, ANOVA, Pearson correlations and Kaplan-Meier survival analysis.
Annual incidence was not associated with gender. No significant gender difference in diagnosis age was observed (men: 60.96 years vs. women: 60.16 years). No significant gender differences in tumors' diameter or height were observed. Tumors were more frequently located posterior to the equator in men than in women (42.28% vs. 33.99%; p=0.03). However, men were less likely than women to complain of symptoms prior to the diagnosis (77.10% vs. 84.65%; p=0.04). Men developed metastases more than women (15% vs. 10%; p=0.05). In the subgroup of patients who developed metastases, the time until development of metastases was shorter in men compared with women (metastases 1 and 5 year after diagnosis of UM: 24% vs. 12.96%; 84% vs. 50%, respectively; p=0.01). Men had a worse survival rate than women (5, 10 and 15 years: 83.09% vs. 92.09%; 76.68% vs. 85.12%; 71.63% vs. 77.37%, respectively; p=0.002). No gender difference was observed in the disease's recurrence rate.
No gender differences in UM were observed regarding annual incidence, age, size or recurrence of the tumor. However, men were more likely to develop UM posterior to the equator, though they surprisingly tended to complain less. The prognosis of UM in men was worse than in women. Men developed more metastases and the time from the diagnosis of UM until development of metastases was shorter. Finally, the overall mortality from UM was higher in men compared with women.
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