Liang Xin, Rong Yan, Wang Junming, Zhang Hong
Department of Ophthalmology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, People's Republic of China.
Int J Gen Med. 2021 Sep 4;14:5221-5232. doi: 10.2147/IJGM.S328910. eCollection 2021.
We sought to investigate clinicopathological characteristics correlated with the prognosis of uveal melanoma (UM) patients and find the driving factors of prognosis for ciliary/iris melanoma relative to choroid melanoma.
We collected patients with uveal melanoma between 1983 and 2012 from the Surveillance, Epidemiology, and End Results (SEER) database. Primary outcomes were evaluated as cancer-specific survival (CSS) and overall survival (OS). The Kaplan-Meier analysis was applied for the univariate analysis of CSS and OS and corresponding survival curves. Cox proportional hazards regression was used for multivariate analysis to value hazard ratio (HR) of ciliary body/iris melanoma subgroup versus choroid melanoma subgroup.
A total of 4359 eligible patients were collected in our study. Novel potential prognostic factors for CSS and OS of UM were identified. Age at diagnosis, sex, primary tumor site, histologic subtype, tumor size, the extent of disease, and treatment were the independent prognostic factors for UM patients ( < 0.05). Interestingly, when concerned with the primary site of UM, we found that the ciliary body/iris melanoma subgroup showed significant differences in prognosis (both CSS and OS), sex, histologic type, the extent of disease, and treatment options relative to choroid melanoma subgroup ( < 0.05). Subsequently, stratification analyses suggested that the distinct survival outcomes between the ciliary body/iris melanoma and choroid melanoma subgroups mainly attributed to patient sex, age, tumor size, the extent of disease, and treatment options ( < 0.05).
Age, sex, primary tumor site, histologic subtype, tumor size, the extent of disease, and treatment options are independent prognostic indicators for UM patients. Besides, the ciliary body/iris melanoma subgroup shows worse survival outcomes than choroid melanoma. Our findings offer inspiration to the individual treatment for UM patients with different primary sites.
我们试图研究与葡萄膜黑色素瘤（UM）患者预后相关的临床病理特征，并找出睫状体/虹膜黑色素瘤相对于脉络膜黑色素瘤预后的驱动因素。
我们从监测、流行病学和最终结果（SEER）数据库中收集了1983年至2012年间患有葡萄膜黑色素瘤的患者。主要结局评估为癌症特异性生存（CSS）和总生存（OS）。采用Kaplan-Meier分析对CSS和OS进行单因素分析及相应的生存曲线分析。使用Cox比例风险回归进行多因素分析，以评估睫状体/虹膜黑色素瘤亚组相对于脉络膜黑色素瘤亚组的风险比（HR）。
我们的研究共收集了4359例符合条件的患者。确定了UM患者CSS和OS的新的潜在预后因素。诊断时年龄、性别、原发肿瘤部位、组织学亚型、肿瘤大小、疾病范围和治疗是UM患者的独立预后因素（<0.05）。有趣的是，当关注UM的原发部位时，我们发现睫状体/虹膜黑色素瘤亚组在预后（CSS和OS）、性别、组织学类型、疾病范围和治疗选择方面相对于脉络膜黑色素瘤亚组存在显著差异（<0.05）。随后，分层分析表明，睫状体/虹膜黑色素瘤和脉络膜黑色素瘤亚组之间不同的生存结局主要归因于患者性别、年龄、肿瘤大小、疾病范围和治疗选择（<0.05）。
年龄、性别、原发肿瘤部位、组织学亚型、肿瘤大小、疾病范围和治疗选择是UM患者的独立预后指标。此外，睫状体/虹膜黑色素瘤亚组的生存结局比脉络膜黑色素瘤更差。我们的研究结果为不同原发部位的UM患者的个体化治疗提供了启示。
