Objective:To reportsitesofsecond prim ary cancerand thetim e to firstdiagnosis during routine follow-up after treat-m ent for choroidal m elanom a.Design:Prospective longi-tudinalfollow-up ofpatients enrolled in 2rand...Objective:To reportsitesofsecond prim ary cancerand thetim e to firstdiagnosis during routine follow-up after treat-m ent for choroidal m elanom a.Design:Prospective longi-tudinalfollow-up ofpatients enrolled in 2random ized trialsconducted by the Collaborative Ocular M elanom a Study(COM S)Group.M ethods:Baseline and annual or sem i-annualsystem ic and laboratory evaluations were perform edaccording to a standard protocolfor 2320patients enrolledin the COM S without evidence of m elanom a m etastasis orother prim ary cancer atbaseline.Deaths were coded by am ortality coding com m ittee.Results:Subsequentto treat-m entfor choroidalm elanom a,a totalof222patients werediagnosed with a second prim ary cancerotherthan basalorsquam ous cellskin cancer (5-yearrate of7.7% 犤95%confidence interval,6.6% -9.0%犦).The m ostcom m onsites were prostate (23% of reported cases)and breast(17%);12ofthese 222patients were diagnosed sim ulta-neously with second prim ary cancers in 2orm ore sites.Ofthese 222patients,113died;37 (33%)were coded asdead with m elanom am etastasis,33(29%)as deadwith a-m alignant tum or other than m etastatic m elanom a,and 13(11% )as dead with a m alignancy of uncertain origin.Radio therapy did not significantly increase the develop-m ent of second prim ary cancers.The rate of diagnosis ofsecond prim ary cancer did not differ significantly bysm oking status,although the rate in form er sm okers wasincreased vs that observed in either current sm okers orthose who never sm oked.Conclusion:Routine m edicalsurveillance for developm entofsecond prim ary cancers a-m ong patients treated for choroidalm elanom a is im portant,especially forthose with a history ofsm oking,regardless ofthe size ofchoroidalm elanom a atthe tim e oftreatm ent.展开更多
文摘Objective:To reportsitesofsecond prim ary cancerand thetim e to firstdiagnosis during routine follow-up after treat-m ent for choroidal m elanom a.Design:Prospective longi-tudinalfollow-up ofpatients enrolled in 2random ized trialsconducted by the Collaborative Ocular M elanom a Study(COM S)Group.M ethods:Baseline and annual or sem i-annualsystem ic and laboratory evaluations were perform edaccording to a standard protocolfor 2320patients enrolledin the COM S without evidence of m elanom a m etastasis orother prim ary cancer atbaseline.Deaths were coded by am ortality coding com m ittee.Results:Subsequentto treat-m entfor choroidalm elanom a,a totalof222patients werediagnosed with a second prim ary cancerotherthan basalorsquam ous cellskin cancer (5-yearrate of7.7% 犤95%confidence interval,6.6% -9.0%犦).The m ostcom m onsites were prostate (23% of reported cases)and breast(17%);12ofthese 222patients were diagnosed sim ulta-neously with second prim ary cancers in 2orm ore sites.Ofthese 222patients,113died;37 (33%)were coded asdead with m elanom am etastasis,33(29%)as deadwith a-m alignant tum or other than m etastatic m elanom a,and 13(11% )as dead with a m alignancy of uncertain origin.Radio therapy did not significantly increase the develop-m ent of second prim ary cancers.The rate of diagnosis ofsecond prim ary cancer did not differ significantly bysm oking status,although the rate in form er sm okers wasincreased vs that observed in either current sm okers orthose who never sm oked.Conclusion:Routine m edicalsurveillance for developm entofsecond prim ary cancers a-m ong patients treated for choroidalm elanom a is im portant,especially forthose with a history ofsm oking,regardless ofthe size ofchoroidalm elanom a atthe tim e oftreatm ent.
