Svedman Fernanda Costa, Pillas Demetris, Taylor Aliki, Kaur Moninder, Linder Ragnar, Hansson Johan
Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital Solna, Stockholm, Sweden.
Centre for Observational Research, Amgen Ltd, Uxbridge, UK.
Clin Epidemiol. 2016 May 26;8:109-22. doi: 10.2147/CLEP.S99021. eCollection 2016.
Given the increasing incidence in cutaneous malignant melanoma (CMM) and the recent changes in the treatment landscape, it is important to understand stage-specific overall and recurrence-free survival patterns in Europe. Despite publications such as EUROCARE-5, there is limited information on stage-specific survival for CMM in Europe.
We carried out a systematic literature review to provide an up-to-date summary of stage-specific survival and recurrence-free survival patterns in patients with CMM in Europe. Studies were included if they were published in Medline during the past 12 years and included information on stage-specific survival and/or recurrence in CMM.
Of the 8,749 studies identified, 26 studies were included, representing nine countries. Collectively, the studies covered a population of 152,422 patients and included data from 1978 to 2011. Randomized clinical trials and single-center observational studies comprised the most common study designs, including five large registry-based studies. Stage-specific information for survival and recurrence varied: 5-year overall survival: 95%-100% (stage I), 65%-92.8% (stage II), 41%-71% (stage III), and 9%-28% (stage IV); 5-year relapse-free survival was reported less frequently: 56% (stage II), and 28%-44% (stage III). Studies reporting survival by sentinel node (SN) status reported 5-year overall survival as 80%-95% for negative SN (stage I/II) and 35%-75% for positive SN (stage III) status; recurrence-free survival at 5 years: 76%-90% for negative and 35%-58% for positive SN status. Some studies included comparisons of survival by key patient sociodemographic characteristics, suggesting that these have a substantial influence on survival and recurrence estimates.
The studies identified in this review show large variations in stage-specific overall and recurrence-free survival by study type and by country. Owing to differing study designs and populations, it is difficult to make detailed comparisons. Large population-based studies that include stage-specific survival and recurrence in Europe are therefore important.
鉴于皮肤恶性黑色素瘤（CMM）的发病率不断上升以及近期治疗格局的变化，了解欧洲特定分期的总生存率和无复发生存模式非常重要。尽管有诸如EUROCARE - 5等相关出版物，但欧洲关于CMM特定分期生存率的信息有限。
我们进行了一项系统的文献综述，以提供欧洲CMM患者特定分期生存率和无复发生存模式的最新总结。如果研究在过去12年发表于Medline且包含CMM特定分期生存率和/或复发的信息，则纳入研究。
在识别出的8749项研究中，纳入了26项研究，代表9个国家。这些研究总共涵盖了152422名患者，包含1978年至2011年的数据。随机临床试验和单中心观察性研究是最常见的研究设计类型，其中包括5项基于大型登记处的研究。特定分期的生存和复发信息各不相同：5年总生存率：95% - 100%（I期），65% - 92.8%（II期），41% - 71%（III期），以及9% - 28%（IV期）；5年无复发生存率的报告频率较低：56%（II期），以及28% - 44%（III期）。报告前哨淋巴结（SN）状态生存率的研究显示，SN阴性（I/II期）的5年总生存率为80% - 95%，SN阳性（III期）的为35% - 75%；5年无复发生存率：SN阴性为76% - 90%，SN阳性为35% - 58%。一些研究包括了按关键患者社会人口统计学特征进行的生存比较，表明这些特征对生存和复发估计有重大影响。
本综述中识别出的研究表明，特定分期的总生存率和无复发生存率因研究类型和国家而异。由于研究设计和人群不同，难以进行详细比较。因此，开展包含欧洲特定分期生存和复发情况的大型基于人群的研究很重要。
