Wu Yifan, Shi Lu, Ye Zhiqiang, Zhou Yi, Wang Feiran, Zhang Yulan
Department of Ophthalmology, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
Department of Ophthalmology, The Second Affiliated Hospital, Nanchang University, Nanchang, Jiangxi, China.
Front Surg. 2025 Apr 1;12:1577775. doi: 10.3389/fsurg.2025.1577775. eCollection 2025.
Choroidal melanoma is a rare yet aggressive ocular malignancy, accounting for approximately 85% of all ocular melanomas. This study aimed to investigate the association between treatment modalities and the risk of all-cause mortality and choroidal melanoma-specific mortality, thereby comparing the effects of different treatment modalities on patient prognosis.
Data from patients diagnosed with choroidal melanoma between 2004 and 2021 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. A total of 6,871 cases were included in the analysis. Univariate analysis, stratified analysis, and multiple regression analysis were performed to evaluate all-cause mortality and choroidal melanoma-specific mortality across different treatment modalities. Survival curves for the overall and stratified populations were generated using the Kaplan-Meier method. Choroidal melanoma-specific mortality was estimated using the competing risk regression method of Fine and Gray.
In the fully adjusted model, the radiotherapy-only group exhibited a 45% reduction in all-cause mortality (HR = 0.55, 95% CI = 0.50-0.60, < 0.0001) and a 54% reduction in choroidal melanoma-specific mortality (HR = 0.46, 95% CI = 0.41-0.52, < 0.0001) compared to the surgery-only group. The radiotherapy group demonstrated superior long-term survival outcomes compared to other treatment modalities, with the highest 5-year overall survival (OS) rate of 0.7769 (95% CI = 0.7651-0.7889) and 10-year OS rate of 0.6203 (95% CI = 0.6038-0.6372). Additionally, the radiotherapy group achieved the highest 5-year choroidal melanoma-specific survival (CSS) rate of 0.8615 (95% CI = 0.8514-0.8717) and 10-year CSS rate of 0.7715 (95% CI = 0.7567-0.7866).
Among patients diagnosed with choroidal melanoma, those who underwent radiotherapy alone exhibited significantly higher overall survival (OS) and choroidal melanoma-specific survival rates compared to those who received surgical intervention alone. However, for patients with advanced disease or evidence of metastatic spread, the individualization of treatment regimens remains critically important.
脉络膜黑色素瘤是一种罕见但具有侵袭性的眼部恶性肿瘤，约占所有眼部黑色素瘤的85%。本研究旨在探讨治疗方式与全因死亡率和脉络膜黑色素瘤特异性死亡率之间的关联，从而比较不同治疗方式对患者预后的影响。
从监测、流行病学和最终结果（SEER）数据库中提取2004年至2021年期间诊断为脉络膜黑色素瘤的患者数据。共纳入6871例病例进行分析。进行单因素分析、分层分析和多元回归分析，以评估不同治疗方式下的全因死亡率和脉络膜黑色素瘤特异性死亡率。使用Kaplan-Meier方法生成总体和分层人群的生存曲线。使用Fine和Gray的竞争风险回归方法估计脉络膜黑色素瘤特异性死亡率。
在完全调整模型中，与单纯手术组相比，单纯放疗组的全因死亡率降低了45%（HR = 0.55，95% CI = 0.50 - 0.60，P < 0.0001），脉络膜黑色素瘤特异性死亡率降低了54%（HR = 0.46，95% CI = 0.41 - 0.52，P < 0.0001）。与其他治疗方式相比，放疗组显示出更好的长期生存结果，5年总生存率（OS）最高为0.7769（95% CI = 0.7651 - 0.7889），10年OS率为0.6203（95% CI = 0.6038 - 0.6372）。此外，放疗组的5年脉络膜黑色素瘤特异性生存率（CSS）最高为0.8615（95% CI = 0.8514 - 0.8717），10年CSS率为0.7715（95% CI = 0.7567 - 0.7866）。
在诊断为脉络膜黑色素瘤的患者中，与单纯接受手术干预的患者相比，单纯接受放疗的患者的总生存率（OS）和脉络膜黑色素瘤特异性生存率显著更高。然而，对于晚期疾病或有转移扩散证据的患者，治疗方案的个体化仍然至关重要。
