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Yusra Fatima Shao, Nakul Singh, Arun D Singh; Variability of “Bad Prognosis” in Uveal Melanoma. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3632.
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© ARVO (1962-2015); The Authors (2016-present)
To compare published survival data for uveal melanoma undergoing prognostic testing and to explore reasons for variability in reported survival of patients with poor prognosis
We searched PUBMED, MEDLINE and EMBASE for studies reporting survival data for uveal melanoma undergoing prognostic testing with chromosome 3 status by fluorescein in situ hybridization (FISH), comparative genomic hybridization (CGH), microsatellite analysis (MSA), multiplex ligation dependent probe amplification (MLPA), single nucleotide polymorphism (SNP), gene expression profiling (GEP) class and exon sequencing. Only studies reporting 1 year, 3 year and/ or 5 year survival were included in the study. Reported survival data was extracted and projected for comparison.
Initial search resulted 46 studies. Only 10 studies met inclusion criteria. 3 studies reported survival data for FISH, 1 for CGH, 1 for MSA , 3 for MLPA, 3 for SNP, 3 for GEP. No studies reported survival data for exon sequencing.3 studies reported overall survival (OS), 3 reported percent free of metastatic death, 2 reported metastasis free survival (MFS), 1 reported probability of metastasis and 1 reported probability of melanoma related death. Metastasis free survival was considered equivalent to percent free of metastatic death and reverse of probability of melanoma related death.OS (5 year) for monosomy 3 by FISH was 40%, for monosomy 3 and disomy 8 by MLPA was 95% and for class 2 by GEP was 55%. Metastasis free survival (5 year) for monosomy 3 by FISH was 50%, monosomy 3 by MLPA was 35-40%, monosomy 3 by SNP was 22.5%, and for Class 2 by GEP was 15%. Probability of metastasis by 5 years for monosomy 3 by MSA was not reported.
Great variability exists in reported survival for uveal melanoma undergoing prognostic testing. This is related to the type of prognostic test used, heterogeneity within tumors, and method of obtaining tumor sample, variability of median follow up, and variability in patient population (tumor size, exclusion of iris melanoma, determination of metastases). Furthermore, use of variable outcome measure between studies makes it difficult to compare prognostic data. Standardization of study population and outcome measures will allow objective comparison of survival data for different prognostic tests available for uveal melanoma.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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