Shao Yusra F, Echegaray Jose J, Singh Nakul, Singh Arun D
Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
Ophthalmic Oncology, Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.
Ophthalmol Retina. 2019 Feb;3(2):186-193. doi: 10.1016/j.oret.2018.09.007. Epub 2018 Sep 21.
Survival of patients with uveal melanoma classified to have a bad prognosis.
To explore reasons for reported variability in survival of patients with uveal melanoma classified to have a bad prognosis.
We searched PUBMED, MEDLINE, and EMBASE for studies reporting survival data for uveal melanoma undergoing prognostic testing with chromosome 3 status by fluorescence in situ hybridization (FISH), comparative genomic hybridization (CGH), microsatellite analysis (MSA), multiplex ligation-dependent probe amplification (MLPA), single nucleotide polymorphism (SNP), gene expression profiling (GEP) class, and exon sequencing. Only studies reporting 1-year, 3-year, or 5-year survival were included in the study.
The initial search resulted in 49 studies. Only 12 studies met inclusion criteria. Three studies reported survival data for FISH, 1 study reported survival data for CGH, 1 study reported survival data for MSA, 3 studies reported survival data for MLPA, 3 studies reported survival data for SNP, 3 studies reported survival data for GEP, and 2 studies reported survival data for a combination of tests. No studies reported survival data for exon sequencing. Six studies reported percent free of metastatic death, 2 studies reported metastasis-free survival (MFS), 2 studies reported overall survival (OS), and 2 studies reported probability of metastasis. Metastasis-free survival (5 years) for monosomy 3 by FISH was 40% to 60%, by MLPA was 30% to 40%, by SNP was 72%, and for GEP class 2 was not reported. Overall survival (5 years) for monosomy 3 and disomy 8 tumors by MLPA and GEP class 2 were not comparable (81% and 55%, respectively).
Variability exists in reported survival for uveal melanoma with a bad prognosis. Several factors, including composition of study population (tumor size, exclusion of iris melanoma, duration of median follow-up), method of obtaining tumor sample, type of prognostic test, and use of variable outcome measures, can explain some of the observed differences in survival. Variations in determining the cause of death (metastatic or nonmetastatic) may be the major reason for the observed differences. Standardization of study methods and outcome measures will allow comparison of survival data derived from different prognostic tests.
被归类为预后不良的葡萄膜黑色素瘤患者的生存率
探讨被归类为预后不良的葡萄膜黑色素瘤患者生存率报道存在差异的原因。
我们在PUBMED、MEDLINE和EMBASE中检索了通过荧光原位杂交（FISH）、比较基因组杂交（CGH）、微卫星分析（MSA）、多重连接依赖探针扩增（MLPA）、单核苷酸多态性（SNP）、基因表达谱分析（GEP）类别和外显子测序进行预后检测的葡萄膜黑色素瘤生存数据的研究。本研究仅纳入报告了1年、3年或5年生存率的研究。
初步检索得到49项研究。只有12项研究符合纳入标准。3项研究报告了FISH的生存数据，1项研究报告了CGH的生存数据，1项研究报告了MSA的生存数据，3项研究报告了MLPA的生存数据，3项研究报告了SNP的生存数据，3项研究报告了GEP的生存数据，2项研究报告了联合检测的生存数据。没有研究报告外显子测序的生存数据。6项研究报告了无转移性死亡百分比，2项研究报告了无转移生存期（MFS），2项研究报告了总生存期（OS），2项研究报告了转移概率。FISH检测三体3的无转移生存期（5年）为40%至60%，MLPA为30%至40%，SNP为72%，GEP类别2未报告。MLPA和GEP类别2检测三体3和双体8肿瘤的总生存期（5年）无可比性（分别为81%和55%）。
被归类为预后不良的葡萄膜黑色素瘤生存率报道存在差异。包括研究人群组成（肿瘤大小、虹膜黑色素瘤排除、中位随访时间）、获取肿瘤样本的方法、预后检测类型以及使用可变结局指标等几个因素可以解释观察到的生存率差异。确定死亡原因（转移性或非转移性）的差异可能是观察到差异的主要原因。研究方法和结局指标的标准化将允许比较来自不同预后检测的生存数据。
