Abstract
Abstract: :
Purpose:To investigate the mortality in uveal melanoma from a population based national survey during the period 1960-1998. Methods:The Swedish Cancer Registry, linked to the Causes of Death Registry revealed 2988 cases of uveal melanoma during the period 1960 to 1998. The survival data were analyzed gender specifically. The relative survival rates were calculated, which is the ratio of the observed to the expected survival in a comparable population, taking into account age, sex and calendar period. The excess mortality rate was estimated for the first ten year period after diagnosis of uveal melanoma. The statistics used were Kaplan-Meier survival estimates, and Cox regression when simultaneous influence of gender, age and calendar period on survival was analysed. Results: 1539 males and 1449 females were at risk of dying at the study start. During the first 5 years of follow-up after diagnosis of uveal melanoma 619 males and 491 females died and the 5-year survival rates were estimated to 57.1% for males and 63.5% for females.After 10 years 840 males and 690 females had died which gave a 10-year survival rate of 40.0% for men and 46.2% for women. Relative survival rates were 57.8% for males and 60.8% for females after 10 years, giving cumulative excess mortality estimates of 42.2% and 39.2% for males and females, respectively. Gender and calendar year both showed a statistically significant relation to observed survival (p<0.001 and p=0.010 respectively), taking age at diagnosis into consideration. Female sex and later calendar periods (after 1979) were related to better survival. Conclusion: Data from the Swedish population based Cancer Registry reveals that uveal melanoma carries a high mortality rate, with a 5-year and 10-year survival of 60.1% respective 42.8% for the total population. The survival was significantly better for females compared to males and if the diagnosis of uveal melanoma was made in the time periods after 1979 as compared to the period 1960-1979. Excess mortality was still present after 10 years of follow-up for both the male and female patients.
Keywords: 464 melanoma • 611 uvea • 350 clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology