Uveal melanoma: Long-term survival.

<h4>Purpose</h4>The long-term survival of uveal melanoma patients in the US is not known. We compared long-term survival estimates using relative survival, excess absolute risk (EAR), Kaplan-Meier (KM), and competing risk analyses.<h4>Setting</h4>Population based cohort study...

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Autores principales:	Tomas Radivoyevitch, Emily C Zabor, Arun D Singh
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b20371f19a384f5f83e47d651c65a0ad
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spelling	oai:doaj.org-article:b20371f19a384f5f83e47d651c65a0ad2021-12-02T20:11:19ZUveal melanoma: Long-term survival.1932-620310.1371/journal.pone.0250939https://doaj.org/article/b20371f19a384f5f83e47d651c65a0ad2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0250939https://doaj.org/toc/1932-6203<h4>Purpose</h4>The long-term survival of uveal melanoma patients in the US is not known. We compared long-term survival estimates using relative survival, excess absolute risk (EAR), Kaplan-Meier (KM), and competing risk analyses.<h4>Setting</h4>Population based cohort study.<h4>Study population</h4>Pooled databases from Surveillance, Epidemiology, and End Results data (SEER, SEER-9+SEER-13+SEER-18).<h4>Main outcome measure</h4>Overall Survival (OS), Metastasis Free Survival (MFS) and relative survival, computed directly or estimated via a model fitted to excess mortality.<h4>Results</h4>There were 10678 cases of uveal melanoma spanning a period of 42 years (1975-2016). The median age at diagnosis was 63 years (range 3-99). Over half the patients were still alive at the end of 2016 (53%, 5625). The KM estimates of MFS were 0.729 (0.719, 0.74), 0.648 (0.633, 0.663), and 0.616 (0.596, 0.636) at 10, 20, and 30 years, respectively. The cumulative probabilities of melanoma metastatic death at 10, 20 and 30 years were 0.241 (0.236, 0.245), 0.289 (0.283, 0.294), and 0.301 (0.295, 0.307). In the first 5 years since diagnosis of uveal melanoma, the proportion of deaths attributable to uveal melanoma were 1.3 with rapid fall after 10 years. Death due to melanoma were rare beyond 20 years. Relative survival (RS) plateaued to ~60% across 20 to 30 years. EAR parametric modeling yielded a survival probability of 57%.<h4>Conclusions</h4>Relative survival methods can be used to estimate long term survival of uveal melanoma patients without knowing the exact cause of death. RS and EAR provide more realistic estimates as they compare the survival to that of a normal matched population. Death due to melanoma were rare beyond 20 years with normal life expectancy reached at 25 years after primary therapy.Tomas RadivoyevitchEmily C ZaborArun D SinghPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 5, p e0250939 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tomas Radivoyevitch Emily C Zabor Arun D Singh Uveal melanoma: Long-term survival.
description	<h4>Purpose</h4>The long-term survival of uveal melanoma patients in the US is not known. We compared long-term survival estimates using relative survival, excess absolute risk (EAR), Kaplan-Meier (KM), and competing risk analyses.<h4>Setting</h4>Population based cohort study.<h4>Study population</h4>Pooled databases from Surveillance, Epidemiology, and End Results data (SEER, SEER-9+SEER-13+SEER-18).<h4>Main outcome measure</h4>Overall Survival (OS), Metastasis Free Survival (MFS) and relative survival, computed directly or estimated via a model fitted to excess mortality.<h4>Results</h4>There were 10678 cases of uveal melanoma spanning a period of 42 years (1975-2016). The median age at diagnosis was 63 years (range 3-99). Over half the patients were still alive at the end of 2016 (53%, 5625). The KM estimates of MFS were 0.729 (0.719, 0.74), 0.648 (0.633, 0.663), and 0.616 (0.596, 0.636) at 10, 20, and 30 years, respectively. The cumulative probabilities of melanoma metastatic death at 10, 20 and 30 years were 0.241 (0.236, 0.245), 0.289 (0.283, 0.294), and 0.301 (0.295, 0.307). In the first 5 years since diagnosis of uveal melanoma, the proportion of deaths attributable to uveal melanoma were 1.3 with rapid fall after 10 years. Death due to melanoma were rare beyond 20 years. Relative survival (RS) plateaued to ~60% across 20 to 30 years. EAR parametric modeling yielded a survival probability of 57%.<h4>Conclusions</h4>Relative survival methods can be used to estimate long term survival of uveal melanoma patients without knowing the exact cause of death. RS and EAR provide more realistic estimates as they compare the survival to that of a normal matched population. Death due to melanoma were rare beyond 20 years with normal life expectancy reached at 25 years after primary therapy.
format	article
author	Tomas Radivoyevitch Emily C Zabor Arun D Singh
author_facet	Tomas Radivoyevitch Emily C Zabor Arun D Singh
author_sort	Tomas Radivoyevitch
title	Uveal melanoma: Long-term survival.
title_short	Uveal melanoma: Long-term survival.
title_full	Uveal melanoma: Long-term survival.
title_fullStr	Uveal melanoma: Long-term survival.
title_full_unstemmed	Uveal melanoma: Long-term survival.
title_sort	uveal melanoma: long-term survival.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/b20371f19a384f5f83e47d651c65a0ad
work_keys_str_mv	AT tomasradivoyevitch uvealmelanomalongtermsurvival AT emilyczabor uvealmelanomalongtermsurvival AT arundsingh uvealmelanomalongtermsurvival
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Uveal melanoma: Long-term survival.

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