Background: Uveal melanoma (UM) is a rare intraocular tumor with a dismal prognosis once metastasized. This study provides a nationwide overview and time trends of patients diagnosed with primary UM in the Netherlands between 1989 and 2019. Methods: A retrospective population-based cohort study based on patients with primary UM from the database of the Netherlands Cancer Registry (NCR), linked with the national population registry Statistics Netherlands on inhabitants’ cause of death. Two time periods (1989–2004, 2005–2019) were compared with descriptive statistics. Kaplan–Meier and (multivariate) Cox proportional hazard models were used to assess changes over time for overall survival (OS) and cancer-specific survival (CSS). Results: In total, 5036 patients were analyzed with a median age of 64.0 years at the time of diagnosis. The number of patients increased over time. In the first (1989–2004) and second (2005–2019) period, 32% versus 54% of the patients received radiotherapy (p< 0.001). The median FU time was 13.4 years. The median OS of the first and second periods was 9.5 (95% CI 8.7–10.3) versus 11.3 years (95% CI 10.3–12.3;p< 0.001). The median CSS was 30.0 years (95% CI NA) in the first period and not reached in the second period (p= 0.008). In multivariate analysis (MVA), female gender (HR 0.85; 95% CI 0.79–0.92,p< 0.001) and radiotherapy treatment (HR 0.73; 95% CI 0.64–0.83,p< 0.001) were associated with better OS. Radiotherapy treatment (HR 0.74; 95% CI 0.61–0.90,p= 0.002) was also associated with better CSS. The period of diagnosis was not associated with OS or CSS. Conclusions: In this study of patients with primary UM, there was a shift to the diagnosis of smaller tumors, possibly due to stage migration. There was also an increase in eye-preserving treatments over time. OS and CSS were modestly improved in the second time period; however, the time period was not associated with OS or CSS in multivariate analyses.
背景：葡萄膜黑色素瘤（UM）是一种罕见的眼内肿瘤，一旦发生转移预后极差。本研究旨在全面概述1989年至2019年间荷兰原发性UM患者的全国性流行病学特征及其时间趋势。方法：基于荷兰癌症登记处（NCR）数据库中原发性UM患者数据，结合荷兰国家人口登记处的居民死因统计信息，开展一项回顾性人群队列研究。采用描述性统计方法比较两个时间段（1989–2004年与2005–2019年）的差异。通过Kaplan-Meier法和（多变量）Cox比例风险模型评估总生存期（OS）与癌症特异性生存期（CSS）随时间的变化趋势。结果：共纳入5036例患者，诊断时中位年龄为64.0岁。患者数量随时间推移呈增长趋势。在第一阶段（1989–2004年）和第二阶段（2005–2019年），接受放射治疗的患者比例分别为32%和54%（p<0.001）。中位随访时间为13.4年。两个时间段的中位OS分别为9.5年（95% CI 8.7–10.3）和11.3年（95% CI 10.3–12.3；p<0.001）；中位CSS在第一阶段为30.0年（95% CI不可用），第二阶段未达到（p=0.008）。多变量分析显示，女性（HR 0.85；95% CI 0.79–0.92，p<0.001）与放射治疗（HR 0.73；95% CI 0.64–0.83，p<0.001）与更优的OS相关；放射治疗（HR 0.74；95% CI 0.61–0.90，p=0.002）亦与更优的CSS相关。诊断时期与OS或CSS无显著关联。结论：本研究表明原发性UM患者的肿瘤体积呈现小型化趋势，可能与分期迁移现象相关。保眼治疗比例随时间推移显著增加。第二阶段患者的OS与CSS略有改善，但多变量分析显示诊断时期并非OS或CSS的独立影响因素。
肿瘤(癌症)患者之家