Stålhammar Gustav, Herrspiegel Christina
St. Erik Eye Hospital, Box 4078, Solna, 171 04 Stockholm, Sweden.
Department of Clinical Neuroscience, Karolinska Institutet, Tomtebodavägen 18A, plan 5, 171 77 Stockholm, Sweden.
Commun Med (Lond). 2022 Mar 1;2:18. doi: 10.1038/s43856-022-00082-y. eCollection 2022.
A large proportion of patients with uveal melanoma develop metastases and succumb to their disease. Reports on the size of this proportion vary considerably.
PubMed, Web of Science and Embase were searched for articles published after 1980. Studies with ≥100 patients reporting ≥five-year relative survival rates were included. Studies solely reporting Kaplan-Meier estimates and cumulative incidences were not considered, due to risk for competing risk bias and classification errors. A meta-analysis was performed using random-effects and weighted averages models, as well as a combined estimate based on curve fitting.
Nine studies and a total of 18 495 patients are included. Overall, the risk of selective reporting bias is low. Relative survival rates vary across the population of studies (I 48 to 97% and < 0.00001 to 0.15), likely due to differences in baseline characteristics and the large number of patients included (τ < 0.02). The 30-year relative survival rates follow a cubic curve that is well fitted to data from the random-effects inverse-variance and weighted average models ( = 0.95, = 7.19E). The estimated five, ten, 15, 20, 25 and 30-year relative survival rates are 79, 66, 60, 60, 62 and 67%, respectively.
The findings suggest that about two in five of all patients with uveal melanoma ultimately succumb to their disease. This indicates a slightly better prognosis than what is often assumed, and that patients surviving 20 years or longer may have a survival advantage to individuals of the same sex and age from the general population.
很大一部分葡萄膜黑色素瘤患者会发生转移并死于该疾病。关于这一比例大小的报道差异很大。
检索了PubMed、科学网和Embase中1980年后发表的文章。纳入了患者≥100例且报告了≥5年相对生存率的研究。由于存在竞争风险偏差和分类错误的风险，仅报告Kaplan-Meier估计值和累积发病率的研究未被纳入。使用随机效应和加权平均模型以及基于曲线拟合的合并估计值进行了荟萃分析。
纳入了9项研究，共18495例患者。总体而言，选择性报告偏倚的风险较低。相对生存率在各项研究人群中有所不同（I²为48%至97%，P<0.00001至0.15），这可能是由于基线特征的差异以及纳入的患者数量较多（τ<0.02）。30年相对生存率呈三次曲线，与随机效应逆方差和加权平均模型的数据拟合良好（R²=0.95，P=7.19E）。估计的5年、10年、15年、20年、25年和30年相对生存率分别为79%、66%、60%、60%、62%和67%。
研究结果表明，所有葡萄膜黑色素瘤患者中约五分之二最终死于该疾病。这表明预后比通常认为的略好，并且存活20年或更长时间的患者可能比同性别、同年龄的一般人群个体具有生存优势。
