原发灶不明的转移性黑色素瘤比已知原发灶的转移性黑色素瘤预后更好：一项观察性研究的系统评价和荟萃分析。
Metastatic melanomas of unknown primary show better prognosis than those of known primary: a systematic review and meta-analysis of observational studies.
机构信息
Department of Dermatology, St Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; Department of Dermatology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seoul, Korea.
Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
出版信息
J Am Acad Dermatol. 2015 Jan;72(1):59-70. doi: 10.1016/j.jaad.2014.09.029. Epub 2014 Nov 1.
BACKGROUND
Melanoma of unknown primary (MUP) is a condition of metastatic melanoma without a primary lesion.
OBJECTIVE
We sought to identify the prognosis of MUP compared with melanoma of known primary (MKP).
METHODS
We searched for observational studies containing at least 10 patients with MUP from MEDLINE and EMBASE from inception to December 22, 2012. The outcomes of interest were overall and disease-free survival; meta-analyses of hazard ratio stratified by stage using a random effects model were performed. In addition, second systematic review identified risk factors influencing the survival of patients with MUP.
RESULTS
Eighteen studies including 2084 patients with MUP and 5894 with MKP were included. MUP had a better overall survival compared with MKP in stage III (15 studies; hazard ratio 0.83, 95% confidence interval 0.73-0.96, P = .010) and stage IV (6 studies; hazard ratio 0.85, 95% confidence interval 0.75-0.96, P = .008). Secondly, 22 studies including 3312 patients with MUP were reviewed, and increased stage and old age were the risk factors in patients with MUP.
LIMITATIONS
Diverse observational studies were reviewed, and selection and reporting biases are possible.
CONCLUSIONS
The current meta-analyses suggest better survival outcomes in patients with MUP than those in patients with MKP with the same corresponding tumor stage.
背景
原发灶不明的黑色素瘤（MUP）是一种转移性黑色素瘤而无原发性病灶的疾病。
目的
我们旨在比较 MUP 与已知原发性黑色素瘤（MKP）的预后。
方法
我们检索了从 MEDLINE 和 EMBASE 数据库建库至 2012 年 12 月 22 日收录的至少包含 10 例 MUP 患者的观察性研究。我们关注的结局包括总生存率和无病生存率；采用随机效应模型分层分析风险比的荟萃分析。此外，我们还进行了第二项系统综述，以确定影响 MUP 患者生存的危险因素。
结果
纳入了 18 项研究，共包括 2084 例 MUP 患者和 5894 例 MKP 患者。在 III 期（15 项研究；风险比 0.83，95%置信区间 0.73-0.96，P=0.010）和 IV 期（6 项研究；风险比 0.85，95%置信区间 0.75-0.96，P=0.008），MUP 的总生存率优于 MKP。其次，我们对包括 3312 例 MUP 患者的 22 项研究进行了综述，结果表明，MUP 患者的分期较高和年龄较大是其危险因素。
局限性
我们对多种观察性研究进行了综述，可能存在选择和报告偏倚。
结论
目前的荟萃分析表明，与具有相同肿瘤分期的 MKP 患者相比，MUP 患者的生存结局更好。
Zotero 插件