An evaluation of the influence of reproductive factors on the risk of metastases from uveal melanoma.
BACKGROUND
There is a paucity of data concerning the possible role played by hormonal factors in the risk of metastases from intraocular melanomas.


METHODS
The authors studied the influence of post-diagnosis pregnancy and oral contraceptive use in a group of women of reproductive age (45 or younger) who were treated for uveal melanoma by proton beam irradiation. A baseline reproductive history had been collected before irradiation for all women, and interim reproductive data were collected by mailed questionnaire.


RESULTS
In this age group, the overall rate of metastasis among women was similar to that of men treated during the same interval (adjusted rate ratio: 1.28; 95% confidence interval: 0.62-2.67). A total of 24 full-term pregnancies were reported among the 139 women still menstruating at diagnosis. Twenty-three women reported regular oral contraceptive use. Metastases developed in 15 of the 139 women. Compared with other women in the series, rates of metastases were not higher among the women who reported pregnancies (P = 0.932) or oral contraceptive use (P = 0.424) after diagnosis.


CONCLUSIONS
Although based on limited numbers, results suggest that the hormonal environment has no appreciable influence on risk of metastases in younger women with uveal melanoma.
Egan
K M
KM
Retina Service, Massachusetts Eye and Ear Infirmary, Boston 02114.
Walsh
S M
SM
Seddon
J M
JM
Gragoudas
E S
ES
D000293:Adolescent; D000328:Adult; D002830:Choroid Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D003276:Contraceptives, Oral; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000532:radiotherapy / Q000556:secondary*; D008875:Middle Aged; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy; D011379:Prognosis; D016016:Proportional Hazards Models; D012307:Risk Factors; D012737:Sex Factors; D016019:Survival Analysis
D003276:Contraceptives, Oral