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单机构对葡萄膜黑色素瘤肝转移患者的纵向经验的结果评估。

An Outcome Assessment of a Single Institution's Longitudinal Experience with Uveal Melanoma Patients with Liver Metastasis.

作者信息

Seedor Rino S, Eschelman David J, Gonsalves Carin F, Adamo Robert D, Orloff Marlana, Amjad Anjum, Sharpe-Mills Erin, Chervoneva Inna, Shields Carol L, Shields Jerry A, Mastrangelo Michael J, Sato Takami

机构信息

Department of Medical Oncology, Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA.

Department of Radiology, Thomas Jefferson University, Philadelphia, PA 19107, USA.

出版信息

Cancers (Basel). 2020 Jan 1;12(1):117. doi: 10.3390/cancers12010117.

Abstract

There is no FDA-approved treatment for metastatic uveal melanoma (UM) and overall outcomes are generally poor for those who develop liver metastasis. We performed a retrospective single-institution chart review on consecutive series of UM patients with liver metastasis who were treated at Thomas Jefferson University Hospital between 1971-1993 (Cohort 1, = 80), 1998-2007 (Cohort 2, = 198), and 2008-2017 (Cohort 3, = 452). In total, 70% of patients in Cohort 1 received only systemic therapies as their treatment modality for liver metastasis, while 98% of patients in Cohort 2 and Cohort 3 received liver-directed treatment either alone or with systemic therapy. Median Mets-to-Death OS was shortest in Cohort 1 (5.3 months, 95% CI: 4.2-7.0), longer in Cohort 2 (13.6 months, 95% CI: 12.2-16.6) and longest in Cohort 3 (17.8 months, 95% CI: 16.6-19.4). Median Eye Tx-to-Death OS was shortest in Cohort 1 (40.8 months, 95% CI: 37.1-56.9), and similar in Cohort 2 (62.6 months, 95% CI: 54.6-71.5) and Cohort 3 (59.4 months, 95% CI: 56.2-64.7). It is speculated that this could be due to the shift of treatment modalities from DTIC-based chemotherapy to liver-directed therapies. Combination of liver-directed and newly developed systemic treatments may further improve the survival of these patients.

摘要

美国食品药品监督管理局(FDA)尚未批准用于治疗转移性葡萄膜黑色素瘤(UM)的疗法,对于发生肝转移的患者而言,总体预后通常较差。我们对1971年至1993年(队列1,n = 80)、1998年至2007年(队列2,n = 198)以及2008年至2017年(队列3,n = 452)期间在托马斯·杰斐逊大学医院接受治疗的连续系列肝转移UM患者进行了一项单机构回顾性病历审查。总体而言,队列1中70%的患者仅接受全身治疗作为其肝转移的治疗方式,而队列2和队列3中98%的患者单独接受了肝导向治疗或同时接受了全身治疗。队列1中从出现转移到死亡的总生存期(Mets-to-Death OS)中位数最短(5.3个月,95%置信区间:4.2 - 7.0),队列2较长(13.6个月,95%置信区间:12.2 - 16.6),队列3最长(17.8个月,95%置信区间:16.6 - 19.4)。队列1中从眼部治疗到死亡的总生存期(Eye Tx-to-Death OS)中位数最短(40.8个月,95%置信区间:37.1 - 56.9),队列2(62.6个月,95%置信区间:54.6 - 71.5)和队列3(59.4个月,95%置信区间:56.2 - 64.7)相似。据推测,这可能是由于治疗方式从基于达卡巴嗪的化疗转向了肝导向治疗。肝导向治疗与新开发的全身治疗相结合可能会进一步提高这些患者的生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6928/7016993/b0a6a0fdfedf/cancers-12-00117-g001.jpg

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