Abstract
Abstract: :
Purpose: To examine survival from uveal melanomas diagnosed 1986–1999. Methods: We examined data compiled by the Office of National Statistics from nine population–based regional cancer registries covering England and Wales for all adults, diagnosed with primary ocular cancer, excluding eyelid cancer, during the period 1986–1999. Tumours were grouped as intraocular, conjunctival, orbital, lacrimal, and of unspecified site, according to the 9th and 10th revisions of the International Classification of Diseases (ICD–9,–10) and melanoma morphology using the 2nd edition of ICD–Oncology (ICD–02). Our classification for intraocular tumours excluded corneal tumours, which we classified as conjunctival, and included retinal tumours. Primary retinal tumours in adults are most likely to originate in the choroid and to have been misclassified. Cases identified as intraocular melanoma were therefore considered as uveal melanoma. Regression models were used to explore the impact of sex, age and income quintile on relative survival for patients diagnosed with uveal tract melanoma during successive five–year periods of diagnosis. Results: Of 5,519 adults identified with primary ocular cancer, 4,717 had melanomas, of which 4,308 (91%) were eligible for analysis. Two–thirds (67%) of the ocular melanomas were uveal, 5% conjunctival, and 2% orbital. In 26% of ocular melanomas, the sub–site was unspecified. Relative survival from uveal melanoma was 95% at one year and 72% at five years. There was no statistically significant variation in one–year or five–year survival by period of diagnosis, sex or income. Survival did vary with age of diagnosis, older patients having significantly worse survival (P<0.001). Conclusions: Survival from uveal melanoma in England and Wales was significantly lower than in the USA but similar to Sweden, with no variation over the study period. This study provides important, population–based, survival estimates for uveal melanoma, the most common primary intraocular malignancy in adults. Ocular oncology services were established in the UK in 1997 to provide rapid and accurate diagnosis of patients suspected of having ocular malignancy and access to specialised treatment. Five–year relative survival rates, an important indicator of the quality of cancer care, have not changed since the 1980s. These data provide a basis for monitoring survival trends over time and for comparison between countries and social groups.
Keywords: tumors • uvea • clinical (human) or epidemiologic studies: outcomes/complications