Childbearing history associated with improved survival in choroidal melanoma.
BACKGROUND
Research in cutaneous melanoma suggests that women may experience better tumor-dependent survival than men, and some studies have shown that the advantage is specific to childbearing.


OBJECTIVE
To examine whether childbearing may be a favorable prognostic factor in melanoma of the uveal tract.


METHODS
Prospective follow-up study.


METHODS
Hospital.


METHODS
Death from metastatic choroidal melanoma.


METHODS
We evaluated a consecutive series of 1818 patients with choroidal melanoma, 748 parous and 165 nulliparous women and 905 men, after treatment with proton irradiation. Three hundred fifty-two deaths from metastasis were documented in follow-up.


RESULTS
Overall multivariate-adjusted death rates from metastasis were approximately 25% higher in nulliparous women (relative risk [RR], 1.23; 95% confidence interval [CI], 0.83-1.82) and men (RR, 1.25; 95% CI, 1.00-1.56) than in women who had given birth. The protective influence of parity was strongest in the early period following diagnosis and treatment (RR, 1.58; 95% CI, 0.88-2.86, and RR, 1.51; 95% CI, 1.04-2.19, in nulliparous women and men, respectively, during the first 36 months of follow-up). The level of protection increased with the number of live births (P for trend, .04).


CONCLUSIONS
These data provide support for the hypothesis that a history of childbearing confers protection from death in choroidal melanoma.
Massachusetts Eye and Ear Infirmary, Department of Epidemiology, Harvard School of Public Health, Boston 02114-3096, USA. Kathleen.Egan@channing.harvard.edu
K M
KM
Egan
J L
JL
Quinn
E S
ES
Gragoudas
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002830:Choroid Neoplasms / Q000401:mortality* / Q000532:radiotherapy; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008545:Melanoma / Q000401:mortality* / Q000532:radiotherapy; D008875:Middle Aged; D011247:Pregnancy; D011446:Prospective Studies; D012044:Regression Analysis; D017584:Reproductive History; D012737:Sex Factors; D015996:Survival Rate