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Epidemiology and Biostatistics
July 1999

Childbearing History Associated With Improved Survival in Choroidal Melanoma

Author Affiliations

From the Retina Service, Massachusetts Eye and Ear Infirmary (Drs Egan and Gragoudas and Ms Quinn), and the Department of Epidemiology, Harvard School of Public Health (Dr Egan), Boston, Mass.

Arch Ophthalmol. 1999;117(7):939-942. doi:10.1001/archopht.117.7.939
Abstract

Background  Research in cutaneous melanoma suggests that women may experience better tumor-dependent survival than men, and some studies have shown that the advantange is specific to childbearing.

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

Design  Prospective follow-up study.

Setting  Hospital.

Main Outcome Measure  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).

Conclusion  These data provide support for the hypothesis that a history of childbearing confers protection from death in choroidal melanoma.

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