Effectiveness of treatments for metastatic uveal melanoma.
OBJECTIVE
To evaluate and comment on published peer-reviewed literature for evidence of effectiveness of treatments for metastatic uveal melanoma.


METHODS
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.
Augsburger
James J
JJ
Department of Ophthalmology, University of Cincinnati College of Medicine, Cincinnati, Ohio 45267, USA.
Corrêa
Zélia M
ZM
Shaikh
Adeel H
AH
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D006801:Humans; D007167:Immunotherapy; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D008545:Melanoma / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D017712:Peer Review, Research; D011878:Radiotherapy; D012878:Skin Neoplasms / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome; D014604:Uveal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*
D000970:Antineoplastic Agents