Abstract
Epidemiological studies of malignant primary conjunctival tumors are rare. We extracted data pertaining to primary site-labeled conjunctival cancer patients present within the Surveillance, Epidemiology, and End Results (SEER) database from 1992 to 2001 and from 2002 to 2011. The Kaplan-Meier approach was used for comparisons of overall survival (OS) between patients, while OS-related risk factors were identified via a Cox proportional hazards regression approach. We then constructed a nomogram that could be used to predict the 3- and 5-year OS, with the accuracy of this predictive model based on receiver operating characteristic (ROC) curve. We observed a significant reduction in age-adjusted incidence of conjunctival cancer in the 50-69-year-old age group of the 2002-2011 cohort relative to the 1992-2001 cohort (APC, P < 0.05). There were no significant differences in OS between the 1992-2001 and 2002-2011 conjunctival cancer patient cohorts. Being ≥30 years old (P < 0.05), male (P < 0.001), single (P < 0.05), divorced (P < 0.001), or widowed (P < 0.001) were all associated with an increased OS-related risk of primary conjunctival cancer (1992-2011). Our nomogram was able to accurately predict 3- and 5-year OS in conjunctival cancer patients. In verification mode, the 3-year area under the curve (AUC) was 0.697 and the 5-year AUC was 0.752. We found that age, sex, and marital status were all associated with primary conjunctival cancer survival. Our results further suggest that conjunctival cancer incidence and survival rates have been relatively stable over the last two decades, and using these data, we were able to generate a satisfactory risk prediction model for this disease.
Highlights
Conjunctival cancers can arise due to the metastasis of other cancers such as breast cancer [1], mucosal gastric cancer [2], or epidermodysplasia verruciformis [3], or they can manifest as primary cancers [4]
While conjunctival cancers are relatively uncommon, one study of 5002 cases of patients with these tumors that were referred to an ocular oncology tertiary care center found that they were malignant in up to 30% of patients [5]
We obtained data pertaining to cases of conjunctival cancer for which primary site information was available within the population-based database managed by the National Cancer Institute SEER Program
Summary
Conjunctival cancers can arise due to the metastasis of other cancers such as breast cancer [1], mucosal gastric cancer [2], or epidermodysplasia verruciformis [3], or they can manifest as primary cancers [4]. Malignant conjunctival tumors account for over 3% of total malignancies [6] The etiology of this disease, and of primary conjunctival cancer, is still not well defined. Few studies have explored risk factors associated with the epidemiology of primary site-labeled conjunctival tumors, patient survival duration, and patient prognosis. In the present study, we assessed a number of epidemiological trends associated with such tumor age-adjusted incidence rate trends, cause-specific survival, and associated risk factors related to survival time in cases of malignant. BioMed Research International primary conjunctival tumors diagnosed in 1992–2001 and in 2002–2011 using the SEER database. By leveraging these data, we were able to develop and validate a clinical prognostic model for patients with malignant primary site-labeled conjunctival tumors
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