TY - JOUR
T1 - Effectiveness of Treatments for Metastatic Uveal Melanoma
AU - Augsburger, James J.
AU - Corrêa, Zélia M.
AU - Shaikh, Adeel H.
N1 - Funding Information:
This study was supported in part by an Unrestricted Grant from Research to Prevent Blindness Inc, New York, New York, to the Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio (Dr Augsburger, Chairman); and by the Quest for Vision Fund of the Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio (Dr Augsburger). The authors indicate no financial conflict of interest. Involved in design of study (J.J.A.); conduct of study (J.J.A., Z.M.C.); management, analysis, and interpretation of data (J.J.A., Z.M.C.); data collection (J.J.A.); MEDLINE search (J.J.A.); review of abstracts (J.J.A.); detailed review and classification of identified articles (J.J.A., Z.M.C., A.H.S.); and preparation and review of manuscript (J.J.A., Z.M.C., A.H.S.). This manuscript is partially based on a presentation at the Annual Meeting of the American Ophthalmological Society that was published subsequently in the Transactions of the American Ophthalmological Society in 2008. The manuscript underwent subsequent updating and review by the authors to comply with the AJO guidelines for submission to peer-review process.
PY - 2009/7
Y1 - 2009/7
N2 - Purpose: To evaluate and comment on published peer-reviewed literature for evidence of effectiveness of treatments for metastatic uveal melanoma. Design: Analytical nonexperimental study of published peer-reviewed data. Methods: Literature search and analysis of pertinent articles published between January 1, 1980 and June 30, 2008. Results: Of 80 identified publications, 12 (15.0%) were review articles without original information, 2 (2.5%) were review articles combined with case reports, 22 (27.5%) were case reports, 16 (20.0%) were retrospective descriptive case series reports, 3 (3.75%) were pilot studies of a novel intervention, 2 (2.5%) were prospective phase I clinical trials, 8 (10.0%) were prospective phase I/II clinical trials, and 15 (18.75%) were prospective phase II clinical trials. None of the articles reported a prospective, randomized phase III clinical trial. The largest reported unselected patient groups had a median survival of 3 to 4 months after detection of metastasis, whereas the largest selected patient groups showed substantially longer median survival times. Conclusions: Although median survival time after diagnosis of metastatic uveal melanoma tends to be substantially longer in selected patient subgroups subjected to aggressive invasive interventions than it is in unselected groups, much if not most of this apparent difference in survival is likely to be attributable to selection bias, surveillance bias, and publication bias rather than treatment-induced alteration of expected outcome. Published peer-reviewed articles do not provide compelling scientific evidence of any survival benefit of any method of treatment for any subgroup of patients with metastatic uveal melanoma.
AB - Purpose: To evaluate and comment on published peer-reviewed literature for evidence of effectiveness of treatments for metastatic uveal melanoma. Design: Analytical nonexperimental study of published peer-reviewed data. Methods: Literature search and analysis of pertinent articles published between January 1, 1980 and June 30, 2008. Results: Of 80 identified publications, 12 (15.0%) were review articles without original information, 2 (2.5%) were review articles combined with case reports, 22 (27.5%) were case reports, 16 (20.0%) were retrospective descriptive case series reports, 3 (3.75%) were pilot studies of a novel intervention, 2 (2.5%) were prospective phase I clinical trials, 8 (10.0%) were prospective phase I/II clinical trials, and 15 (18.75%) were prospective phase II clinical trials. None of the articles reported a prospective, randomized phase III clinical trial. The largest reported unselected patient groups had a median survival of 3 to 4 months after detection of metastasis, whereas the largest selected patient groups showed substantially longer median survival times. Conclusions: Although median survival time after diagnosis of metastatic uveal melanoma tends to be substantially longer in selected patient subgroups subjected to aggressive invasive interventions than it is in unselected groups, much if not most of this apparent difference in survival is likely to be attributable to selection bias, surveillance bias, and publication bias rather than treatment-induced alteration of expected outcome. Published peer-reviewed articles do not provide compelling scientific evidence of any survival benefit of any method of treatment for any subgroup of patients with metastatic uveal melanoma.
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U2 - 10.1016/j.ajo.2009.01.023
DO - 10.1016/j.ajo.2009.01.023
M3 - Article
C2 - 19375060
AN - SCOPUS:67349216128
SN - 0002-9394
VL - 148
SP - 119
EP - 127
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 1
ER -