To the Editor Fry and coworkers1 concluded in their recent article in JAMA Ophthalmology titled “Clinical Features, Metastasis, and Survival in Patients Younger Than 21 Years With Posterior Uveal Melanoma” that patients younger than 21 years appear to have a similar, if not worse, prognosis than patients with posterior uveal melanoma in the population overall. Their experience contradicts what is, to our knowledge, the largest published study on posterior uveal melanoma in children and young adults so far.2 That study included 299 patients from 24 centers, of whom 114 were children younger than 18 years and 185 were adults aged 18 to 24 years. It found a more favorable survival than is generally found, especially among the children. The survival was 97% for children and 90% for young adults at 5 years after diagnosis and 92% for children and 80% for young adults at 10 years. Fry et al1 reported a far worse survival proportion in children (69% at 5 years after diagnosis and 52% at 10 years after diagnosis). Another difference was that male patients tended to have a more favorable survival among children than female patients in the larger study (100% vs 85% at 10 years after diagnosis),2 as opposed to a worse survival for male patients than female patients early on in the study by Fry et al1 (calculated to be 44% vs 90% at 5 years after diagnosis and 44% vs 60% at 10 years after diagnosis).
Al-Jamal RT, Cassoux N, Kivelä TT. Survival of Young Patients With Posterior Uveal Melanoma. JAMA Ophthalmol. 2019;137(9):1091. doi:10.1001/jamaophthalmol.2019.2546
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