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T. V. Johnson, J. Wells, C. Bergstrom; Hispanic Ethnicity Impacts Presentation, Treatment, and Survival of Uveal Melanoma: A Seer Study. Invest. Ophthalmol. Vis. Sci. 2010;51(13):854.
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Uveal melanoma is a rare disease that arises predominantly in the choroid and ciliary body. Studies have investigated the impact of Hispanic ethnicity on the incidence of uveal melanoma. However, the impact of Hispanic ethnicity on the presentation, treatment, and outcomes of uveal melanoma remain unknown. Therefore we conducted this investigation of the Surveillance, Epidemiology, and End Results (SEER) Database.
We queried the 17 SEER registries for Hispanic white (HW) and Non-Hispanic White (NHW) patients diagnosed with primary uveal melanoma from 1990 through 2006. Univariate and multivariate analyses examined predictors of receiving enucleation and radiation therapy. Cox regression analyses assessed overall relative survival (ORS) and cancer-specific survival (CSS) across patient- and disease-related characteristics.
NHWs and HWs constituted 94.7% and 5.3% of the 2,070 patients who met inclusion criteria, respectively. HWs presented nearly a decade earlier in life (mean +/- SD age: 53.6 +/- 16.9) versus NHWs (mean +/- age: 60.1 +/- 15.3) (p<0.001) and with more advanced disease (p=0.036). HWs were more likely to receive enucleation (OR: 1.737, 95% CI: 1.184-2.547) and less likely to receive radiation therapy (OR: 0.638, 95% CI: 0.436-0.933). Controlling for presentation and treatment differences, HWs experienced no difference in ORS or CSS.
HWs and NHWs significantly differ in presentation and treatment of uveal melanoma. These disparities likely lead to increased morbidity. However, HWs do not experience decreased survival. Future efforts are needed to understand and overcome potential genetic, environmental, biological, and socioeconomic contributors to these differences in presentation and treatment of uveal melanomas among Hispanic and Non-Hispanic White patients.
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