Uveal melanoma: Long-term survival

Area of Science:

• Ophthalmology
• Oncology
• Biostatistics

Background:

• Uveal melanoma is the most common primary intraocular malignancy.
• Accurate long-term survival data for uveal melanoma patients are crucial for prognostication and treatment planning.

Purpose of the Study:

• To estimate the long-term survival of uveal melanoma patients in the United States.
• To compare different statistical methods for survival estimation, including relative survival, excess absolute risk (EAR), Kaplan-Meier (KM), and competing risk analyses.

Main Methods:

• A population-based cohort study utilizing pooled data from the Surveillance, Epidemiology, and End Results (SEER) databases (SEER-9, SEER-13, and SEER-18).
• Analysis included Overall Survival (OS), Metastasis Free Survival (MFS), and relative survival, with direct computation or model-fitted excess mortality.
• Data spanned 42 years (1975-2016) and included 10,678 uveal melanoma cases.

Main Results:

• Over half of the patients (53%) were alive at the end of 2016.
• Metastasis Free Survival (MFS) estimates at 10, 20, and 30 years were 0.729, 0.648, and 0.616, respectively.
• Deaths due to melanoma were rare beyond 20 years, with relative survival plateauing around 60% from 20 to 30 years.

Conclusions:

• Relative survival (RS) and excess absolute risk (EAR) methods are valuable for estimating long-term uveal melanoma survival without needing exact causes of death.
• These methods offer realistic survival probabilities by comparing patient survival to a matched normal population.
• Patients typically reach normal life expectancy approximately 25 years after primary therapy for uveal melanoma.