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Mary E Aronow, Allan K Topham, Arun D Singh; Uveal Melanoma: 5 Year Update on Incidence, Treatment, and Survival (SEER 1973-2013). Invest. Ophthalmol. Vis. Sci. 2017;58(8):4411.
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© ARVO (1962-2015); The Authors (2016-present)
As newer therapies evolve, there is a priority to establish baseline data for trends in uveal melanoma using population-based registries. The Survival, Epidemiology, and End Results (SEER) Program provides the most authoritative source of longitudinal epidemiological trends of uveal melanoma that can be meaningfully compared with future studies. The purpose of the present study is to analyze trends in incidence, treatment, and survival of uveal melanoma in the United States over the 41-year period from 1973 to 2013.
We performed a systematic review of existing databases from the Surveillance, Epidemiology, and End Results (SEER) program in the United States from 1973 to 2013. Patients with primary uveal melanoma were identified using International Classification of Disease for Oncology [ICD-O-2] codes including: C69.3 [choroid], C69.4 [ciliary body and iris], and C69.2 [retina]. Trends in age-adjusted incidence, treatment, and 5-year relative survival were calculated using chi-square test and 95% confidence intervals (CI). Age-adjusted incidence, treatment selection (surgery, or radiation), and 5-year relative survival were analyzed.
A total of 4,999 patients with uveal melanoma were identified. The majority (97.8%) were reported by hospital inpatient/outpatient clinics. Histopathologic confirmation was available in 67.8% of cases. The mean age-adjusted incidence of uveal melanoma in the United States was 5.2 per million (5.0 -5.4; 95% CI). There was a decline in the percentage of patients treated with surgery alone (94.2% from 1973-1975 versus 24.7% from 2012-2013). A corresponding increase was observed in radiation as primary treatment selection (1.3% from 1973-1975 versus 68.3% from 2012-2013). No change in age-adjusted incidence (1973-2013) or 5-year relative survival (80.9%) was observed (1973 to 2008).When incidence data were standardized for race, a small but statistically significant (p < 0.05) annual percentage change of 0.5% was detected in Whites alone.
The overall age-adjusted incidence of uveal melanoma (5.2 per million) has remained stable from 1973 to 2013, with a minor increase in Whites. Despite a shift towards globe-preserving treatment, there has not been a concomitant improvement in survival.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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