Sex differences in uveal melanoma

Abstract

Abstract Purpose To determine sex differences in uveal melanomas involving choroid. Methods Patients were included in this study if diagnosed clinically with uveal melanoma and treated after 1992 at the Liverpool Ocular Oncology Service. Survival studies were performed only with patients resident in mainland Britain, for whom accurate data from the NHS Cancer Registries were available. Statistical methods included the Chi‐square test for categorical variables, Mann‐Whitney for continuous variables and log‐rank for survival studies. Results The 3870 patients comprised 1933 females and 1937 males. The mean age at treatment was 60.3 years with no significant difference (p = 0.78. The tumour was considered to arise in choroid in 91.3% of males and 86.0% of females (p<0.001).When only tumours involving choroid were assessed, males were less likely to have a melanoma with pre‐ora extension (p=.001); more likely to have tumour extension to within 2DD of disc or fovea (p = .001); greater basal diameter (p =.036), greater height (p = .003) and epithelioid cellularity (p =.018) but there was no difference in the prevalence of monosomy 3 (p =.574). Males were more likely to have primary enucleation (p = .015). Males showed greater metastatic mortality (p = .003); however, it is uncertain as to whether this difference was caused by bias relating to shorter life expectancy. Conclusion Uveal melanomas tended to be more posterior in males, in whom choroidal melanomas tended to be larger with a higher prevalence of epithelioid cytomorphology. Males were more likely to undergo primary enucleation and showed higher metastatic mortality.