Time Trends in the Treatment and Survival of 5036 Uveal Melanoma Patients in The Netherlands over a 30-Year Period
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Data Retrieval
2.2. Definitions
2.3. Outcome Measures
2.4. Survival
2.5. Statistical Analysis
3. Results
3.1. Study Population
3.2. Treatments
3.3. Overall Survival and Cancer-Specific Survival
3.4. Variables Associated with OS and CSS in UVA
3.5. Variables Associated with OS and CSS in MVA
3.6. Adjusted Models for Period of Diagnosis in MVA
4. Discussion
4.1. Survival over Time
4.2. Treatment over Time
4.3. Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Total N = 5036 (%) | 1989–2004 N = 2209 (%) | 2005–2019 N = 2827 (%) | p-Value | |
---|---|---|---|---|
Gender | 0.72 | |||
Male | 2589 (51) | 1142 (512) | 1447 (51) | |
Female | 2447 (49) | 1067 (48) | 1380 (49) | |
Age at diagnosis | <0.001 | |||
<50 | 857 (17) | 467 (21) | 390 (14) | |
50–70 | 2580 (51) | 1085 (49) | 1495 (53) | |
>70 | 1599 (32) | 657 (30) | 942 (33) | |
Affected eye | <0.001 * | |||
Right | 2496 (49.6) | 1077 (49) | 1419 (50) | |
Left | 2519 (50) | 1113 (50) | 1406 (50) | |
Unknown | 21 (0.4) | 19 (0.9) | ||
Diagnosis confirmation | <0.001 | |||
Clinical and diagnostic assessment | 2220 (44) | 698 (32) | 1522 (54) | |
Cytological analysis | 24 (0.5) | 9 (0.4) | 15 (0.5) | |
Histological analysis | 2782 (55) | 1492 (68) | 1290 (46) | |
Other/unknown | 10 (0.2) | 10 (0.5) | ||
Tumor location in the eye | 0.006 | |||
Choroid | 4305 (86) | 1854 (84) | 2451 (87) | |
Eyeball | 731 (14) | 355 (16) | 376 (13) | |
TNM/AJCC Stage | <0.001 | |||
I | 946 (19) | 427 (19) | 519 (18) | |
II | 2355 (47) | 686 (31) | 1669 (59) | |
III | 1169 (23) | 727 (33) | 442 (16) | |
IV | 163 (3) | 120 (5.4) | 43 (1.5) | |
N/A or unknown | 403 (8) | 249 (11) | 154 (5.4) |
Total N = 5036 (%) | 1989–2004 N = 2209 (%) | 2005–2019 N = 2827 (%) | p-Value | |
---|---|---|---|---|
Surgery | <0.001 | |||
Yes | 2584 (51) | 1437 (65) | 1147 (41) | |
No | 2452 (49) | 772 (35) | 1680 (59) | |
Radiotherapy | <0.001 | |||
Yes | 2250 (45) | 716 (32) | 1534 (54) | |
No | 2786 (55) | 1493 (68) | 1293 (46) | |
Systemic chemotherapy | 0.73 | |||
Yes | 20 (0.4) | 8 (0.4) | 12 (0.4) | |
No | 5016 (99.6) | 2201 (99.6) | 2815 (99.6) | |
Targeted therapy | 0.03 | |||
Yes | 6 (0.1) | 6 (0.2) | ||
No | 5030 (99.9) | 2209 (100) | 2821 (99.8) | |
Other curative treatment * | 0.87 | |||
Yes | 13 (0.3) | 6 (0.3) | 7 (0.2) | |
No | 5023 (99.7) | 2203 (99.7) | 2820 (99.8) | |
Unknown treatment | 0.67 | |||
Yes | 12 (0.2) | 6 (0.3) | 6 (0.2) | |
No | 5024 (99.8) | 2203 (99.7) | 2821 (99.8) | |
Active surveillance | 324 (6.4) | 147 (6.7) | 177 (6.3) |
Factor | Univariate Analyses | Multivariate Analyses | |||||
---|---|---|---|---|---|---|---|
HR | 95% CI | p-Value | HR | 95% CI | p-Value | ||
Age | Cont. | 1.05 | 1.05–1.05 | <0.001 | 1.05 | 1.05–1.06 | <0.001 |
<50 | Ref. | ||||||
Age | 50–70 | 2.32 | 2.03–2.65 | <0.001 | |||
>70 | 5.28 | 4.60–6.06 | <0.001 | ||||
Gender | Male | Ref. | Ref. | ||||
Female | 0.91 | 0.84–0.98 | 0.01 | 0.85 | 0.79–0.92 | <0.001 | |
Tumor stage | I | Ref. | Ref. | ||||
II | 1.38 | 1.23–1.55 | <0.001 | 1.58 | 1.40–1.79 | <0.001 | |
III | 2.20 | 1.95–2.49 | <0.001 | 2.07 | 1.82–2.34 | <0.001 | |
IV | 3.73 | 3.06–4.55 | <0.001 | 2.88 | 2.35–3.54 | <0.001 | |
M/Unknown | 1.32 | 1.12–1.55 | 0.001 | 1.44 | 1.22–1.71 | <0.001 | |
Tumor location | Choroid(ref)/ | 1.02 | 0.92–1.14 | 0.69 | 1.02 | 0.91–1.14 | 0.789 |
Eyeball | |||||||
Period | 1989–2004 | Ref. | Ref. | ||||
2005–2019 | 0.86 | 0.79–0.93 | <0.001 | 0.94 | 0.72–1.26 | 0.15 | |
Surgery | No (ref)/Yes | 1.88 | 1.74–2.04 | <0.001 | 1.39 | 1.22–1.60 | <0.001 |
Radiotherapy | No (ref)/Yes | 0.52 | 0.48–0.57 | <0.001 | 0.73 | 0.64–0.83 | <0.001 |
Other curative treatment | No (ref)/Yes | 3.75 | 2.02–6.99 | <0.001 | 4.29 | 2.30–8.01 | <0.001 |
Factor | Univariate Analyses | Multivariate Analyses | |||||
---|---|---|---|---|---|---|---|
HR | 95% CI | p-Value | HR | 95% CI | p-Value | ||
Age | Cont. | 1.02 | 1.02–1.03 | <0.001 | 1.03 | 1.02–1.04 | <0.001 |
<50 | Ref. | ||||||
Age | 50–70 | 1.67 | 1.44–1.95 | <0.001 | |||
>70 | 2.28 | 1.93–2.68 | <0.001 | ||||
Gender | Male | Ref. | Ref. | ||||
Female | 0.88 | 0.80–0.98 | 0.01 | 0.92 | 0.83–1.02 | 0.12 | |
Tumor stage | I | Ref. | Ref. | ||||
II | 2.20 | 1.83–2.64 | <0.001 | 2.20 | 1.79–2.64 | <0.001 | |
III | 3.83 | 3.19–4.59 | <0.001 | 3.15 | 2.62–3.80 | <0.001 | |
IV | 7.72 | 5.99–9.95 | <0.001 | 5.53 | 4.27–7.17 | <0.001 | |
M/Unknown | 1.51 | 1.17–1.96 | 0.002 | 1.72 | 1.33–2.23 | <0.001 | |
Tumor location | Choroid(ref)/ | 1.02 | 0.89–1.18 | 0.74 | 1.02 | 0.88–1.18 | 0.83 |
Eyeball | |||||||
Period | 1989–2004 | Ref. | Ref. | ||||
2005–2019 | 0.08 | 0.74–0.94 | 0.003 | 1.09 | 0.97–1.22 | 0.13 | |
Surgery | No (ref)/Yes | 2.74 | 1.74–2.04 | <0.001 | 1.84 | 1.52–2.25 | <0.001 |
Radiotherapy | No (ref)/Yes | 0.41 | 0.48–0.57 | <0.001 | 0.74 | 0.61–0.90 | 0.002 |
Other curative treatment | No (ref)/Yes | 5.34 | 2.87–9.95 | <0.001 | 4.46 | 2.38–8.33 | <0.001 |
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Tong, T.M.L.; Bastiaannet, E.; Speetjens, F.M.; Blank, C.U.; Luyten, G.P.M.; Jager, M.J.; Marinkovic, M.; Vu, T.H.K.; Rasch, C.R.N.; Creutzberg, C.L.; et al. Time Trends in the Treatment and Survival of 5036 Uveal Melanoma Patients in The Netherlands over a 30-Year Period. Cancers 2023, 15, 5419. https://doi.org/10.3390/cancers15225419
Tong TML, Bastiaannet E, Speetjens FM, Blank CU, Luyten GPM, Jager MJ, Marinkovic M, Vu THK, Rasch CRN, Creutzberg CL, et al. Time Trends in the Treatment and Survival of 5036 Uveal Melanoma Patients in The Netherlands over a 30-Year Period. Cancers. 2023; 15(22):5419. https://doi.org/10.3390/cancers15225419
Chicago/Turabian StyleTong, Thaïs M. L., Esther Bastiaannet, Frank M. Speetjens, Christian U. Blank, Gregorius P. M. Luyten, Martine J. Jager, Marina Marinkovic, T. H. Khanh Vu, Coen R. N. Rasch, Carien L. Creutzberg, and et al. 2023. "Time Trends in the Treatment and Survival of 5036 Uveal Melanoma Patients in The Netherlands over a 30-Year Period" Cancers 15, no. 22: 5419. https://doi.org/10.3390/cancers15225419