Second Primary Neoplasms in Patients With Uveal Melanoma: A SEER Database Analysis

• Published in: American journal of ophthalmology Vol. 165; pp. 54 - 64
• Main Authors: Laíns, Inês, Bartosch, Carla, Mondim, Vera, Healy, Brian, Kim, Ivana K., Husain, Deeba, Miller, Joan W.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2016; Elsevier Limited
• Subjects: Adolescent; Adult; Child; Child, Preschool; Databases, Factual; Expected values; Female; Health risk assessment; Humans; Incidence; Infant; Male; Melanoma - pathology; Melanoma - radiotherapy; Middle Aged; Neoplasms, Second Primary - epidemiology; Ophthalmology; Proportional Hazards Models; Retrospective Studies; Risk Factors; SEER Program - statistics & numerical data; Skin cancer; Tumors; United States - epidemiology; Uveal Neoplasms - pathology; Uveal Neoplasms - radiotherapy; United States > US
• ISSN: 0002-9394; 1879-1891; 1879-1891
• DOI: 10.1016/j.ajo.2016.02.022

To determine the risk of second primary neoplasms (SPNs) in subjects previously diagnosed with uveal melanoma (UM), including an analysis on whether radiotherapy is a risk factor to develop these SPNs. Retrospective cohort study. Using the Surveillance, Epidemiology, and End Results (SEER) 9 database, we identified patients diagnosed with UM as their first malignancy between 1973 and 2011 (n = 3976). We obtained standardized incidence ratios (SIR) and excess absolute risks of SPNs on patients with UM compared to a reference population. Multivariate Cox regression models were used to evaluate the effect of radiotherapy in SPN risk. Sixteen percent (n = 641) of the patients developed SPNs during a median follow-up of 83 months (range, 1–463 months). This represented an 11% excess risk compared to the reference population, mainly owing to a significantly increased risk of skin melanomas (SIR = 2.93, 95% CI: 2.23–3.78) and kidney tumors (SIR = 1.91, 95% CI: 1.27–2.76), primarily in those diagnosed between 30 and 59 years of age. The occurrence of second UM was also increased (SIR = 16.90, 95% CI: 9.00–28.90), which likely includes recurrences misclassified as a second cancer. Radiotherapy was performed in 39% (n = 1538) of the patients. Multivariate analysis revealed that this treatment was not an independent risk factor for SPNs (hazard ratio = 1.06, 95% CI: 0.88–1.26, P = .54). Patients with UM presented an 11% higher risk of SPNs compared to the reference population. Radiotherapy does not seem to be a risk factor. SPNs should be considered in the surveillance of UM.