Yifan Wu, Lu Shi, Zhiqiang Ye, Yi Zhou, Feiran Wang, Yulan Zhang
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引用次数: 0
Abstract
Background: 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.
Methods: 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.
Results: 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, p < 0.0001) and a 54% reduction in choroidal melanoma-specific mortality (HR = 0.46, 95% CI = 0.41-0.52, p < 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).
Conclusions: 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.
背景：脉络膜黑色素瘤是一种罕见但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风险之间的关系，从而比较不同治疗方式对患者预后的影响。方法：从监测、流行病学和最终结果（SEER）数据库中提取2004年至2021年间诊断为脉络膜黑色素瘤的患者的数据。共有6871例病例被纳入分析。采用单因素分析、分层分析和多元回归分析来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法生成总体和分层种群的生存曲线。使用Fine和Gray竞争风险回归法估计脉络膜黑色素瘤特异性死亡率。结果：在完全调整模型中，仅放疗组的全因死亡率降低了45% （HR = 0.55, 95% CI = 0.50-0.60, p p）。结论：在诊断为脉膜黑色素瘤的患者中，与仅接受手术干预的患者相比，单独接受放疗的患者表现出明显更高的总生存期（OS）和脉膜黑色素瘤特异性生存率。然而，对于疾病晚期或转移性扩散的患者，治疗方案的个体化仍然至关重要。
期刊介绍：
Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles.
Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery.
Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact.
The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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