Variates of survival in metastatic uveal melanoma
Variates of survival in metastatic uveal melanoma
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DOI：
10.1200/jco.2005.02.6534
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发表时间：
2005-11-01
影响因子：
45.3
通讯作者：
Chapman, PB
中科院分区：
文献类型：
--
作者：
Rietschel, P;Panageas, KS;Chapman, PB
目的转移性葡萄膜黑色素瘤的病程和转归尚未得到很好的描述。我们评估了转移性葡萄膜黑色素瘤患者的存活率，描述了与存活率相关的因素，并评估了筛查试验对检测时间和存活率的影响。结果119例患者的中位生存期为12.5个月，4年存活率为22%。与生存时间延长独立相关的有5个变量：肺/软组织是首次转移的唯一部位，手术或肝内治疗，女性，年龄小于60岁，以及从最初诊断到转移疾病的较长时间间隔。在无症状的患者中发现转移性疾病与总存活率无关；89%的患者只有一个器官作为首次转移的部位。虽然肝脏是最常见的部位，但39.5%的患者有非肝脏部位，最常见的是肺，作为第一转移部位。结论大部分转移性葡萄膜黑色素瘤患者存在转移疾病，生存时间超过4年。虽然我们的数据未能显示出在发现无症状转移疾病方面的生存优势，但有关生存变量和首次转移部位的数据可能会指导筛查患者的策略。
Purpose The course and outcome of metastatic uveal melanoma are not well described. We evaluated the survival of our patients with metastatic uveal melanoma, described factors that correlated with survival, and evaluated the influence of screening tests on time of detection and survival.Patients and Methods All patients with metastatic uveal melanoma seen at Memorial Sloan-Kettering Cancer Center between 1994 and 2004 were identified from our database. We recorded date of initial diagnosis, date of metastatic disease, date of last follow-up, site of the first metastasis, how the first metastasis was discovered, treatment, and outcome of therapy.Results The estimated median survival of the 119 patients analyzed was 12.5 months; 22% of patients were alive at 4 years. Five variates correlated independently with prolonged survival: Lung/soft tissue as only site of first metastasis, treatment with surgery or intrahepatic therapy, female sex, age younger than 60, and a longer interval from initial diagnosis to metastatic disease. Discovering metastatic disease in asymptomatic patients did not correlate with overall survival; 89% of patients had a single organ as the site of first metastasis. Although liver was the most common site, 39.5% of patients had nonliver sites, most commonly lung, as the first site of metastasis.Conclusion A substantial subset of patients with metastatic uveal melanoma survive more than 4 years with metastatic disease. Data on variates of survival and site of first metastasis may guide strategies for screening patients, although our data failed to show a survival advantage in discovering asymptomatic metastatic disease.