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James J Augsburger, Zelia M Correa; Has survival time of patients following detection of metastatic uveal melanoma really increased in recent years?. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5099.
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© ARVO (1962-2015); The Authors (2016-present)
During the past decade, numerous treatments that were not available previously have been introduced for management of metastatic uveal melanoma. Many clinicians are convinced (usually on the basis of one or a few anecdotal cases in spite the absence of published reports of any large scale randomized clinical trials) that the various newer treatments prolong patient survival substantially. The authors attempted to determine whether patients with metastatic uveal melanoma encountered in recent years truly have prolonged survival relative to patients encountered during the preceding two decades.
Retrospective analysis of two sequential series of cases of metastatic uveal melanoma encountered in the authors’ private practice. The earlier series (Wills Eye Hospital series, 1980 - 1999) consisted of 320 patients while the more recent series (University of Cincinnati series, 1999-2013) consisted of 81 cases.
The clinical characteristics of the patients (age, gender) and their tumors (largest basal diameter, thickness, intraocular location) at baseline were all quite similar. The mean interval between initial treatment of the primary intraocular tumor and detection of metastasis in the earlier series was substantially longer (49.6 months) than that in the more recent series (35.2 months) . At the same time, the mean interval between detection of metastasis and death was shorter in the earlier series (7.7 months) than in the more recent series (9.5 months). However, comparative actuarial survival curves for length of survival following detection of metastasis showed only a slight difference between the curves with a median survival improvement in the more recent series of only about 2 months.
While this study revealed a slight improvement in survival time of patients with metastatic uveal melanoma in recent years compared with that observed in earlier years, one cannot tell whether this improvement is due to improved effectiveness of current treatments, detection of metastasis at a less advanced substage due to increased and improved surveillance testing, or other factors.
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