Survival in Patients with Multiple Primary Melanomas: Systematic Review and Meta-analysis

View/ Open
File version
Accepted Manuscript (AM)
Author(s)
Peek, Genevieve
Olsen, Catherine M
Baade, Peter
Youlden, Danny R
Aitken, Joanne F
Green, Adele C
Khosrotehrani, Kiarash
Year published
2020
Metadata
Show full item recordAbstract
BACKGROUND: The literature surrounding survival of patients with multiple primary melanomas (MPM) yields variable and opposing findings, constrained by statistical challenges. OBJECTIVES: To critically examine the available literature regarding survival of patients with MPM compared with single primary melanomas (SPM) and detail statistical methods employed. METHODS: Electronic searches of Pubmed, Embase, Web of Science and Scopus, with cross-checking of references, for the period January 1956 - June 2019 were carried out. All studies published in English examining survival in patients with multiple melanoma were included. ...
View more >BACKGROUND: The literature surrounding survival of patients with multiple primary melanomas (MPM) yields variable and opposing findings, constrained by statistical challenges. OBJECTIVES: To critically examine the available literature regarding survival of patients with MPM compared with single primary melanomas (SPM) and detail statistical methods employed. METHODS: Electronic searches of Pubmed, Embase, Web of Science and Scopus, with cross-checking of references, for the period January 1956 - June 2019 were carried out. All studies published in English examining survival in patients with multiple melanoma were included. Case studies and small case series were excluded. RESULTS: Fourteen studies were eligible for inclusion. Conclusions on survival varied markedly depending on the statistical method used. Four studies that accounted for survival bias by partitioning the survival time were included in the quantitative review, with three of these reporting a survival disadvantage for MPM, while the fourth showed no difference in survival. Pooled HR was 1.39 (1.07-1.81) but with significant heterogeneity (I2= 96.8% Phet < 0.001). LIMITATIONS: Studies showed significant heterogeneity in methodology. CONCLUSIONS: When data was analysed with robust statistical methods, patients with MPM had a survival disadvantage compared with patients with SPM.
View less >
View more >BACKGROUND: The literature surrounding survival of patients with multiple primary melanomas (MPM) yields variable and opposing findings, constrained by statistical challenges. OBJECTIVES: To critically examine the available literature regarding survival of patients with MPM compared with single primary melanomas (SPM) and detail statistical methods employed. METHODS: Electronic searches of Pubmed, Embase, Web of Science and Scopus, with cross-checking of references, for the period January 1956 - June 2019 were carried out. All studies published in English examining survival in patients with multiple melanoma were included. Case studies and small case series were excluded. RESULTS: Fourteen studies were eligible for inclusion. Conclusions on survival varied markedly depending on the statistical method used. Four studies that accounted for survival bias by partitioning the survival time were included in the quantitative review, with three of these reporting a survival disadvantage for MPM, while the fourth showed no difference in survival. Pooled HR was 1.39 (1.07-1.81) but with significant heterogeneity (I2= 96.8% Phet < 0.001). LIMITATIONS: Studies showed significant heterogeneity in methodology. CONCLUSIONS: When data was analysed with robust statistical methods, patients with MPM had a survival disadvantage compared with patients with SPM.
View less >
Journal Title
Journal of the American Academy of Dermatology
Copyright Statement
© 2020 The American Academy of Dermatology Inc. Published by Elsevier Ltd. Licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International Licence (http://creativecommons.org/licenses/by-nc-nd/4.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, providing that the work is properly cited.
Note
This publication has been entered in Griffith Research Online as an advanced online version.
Subject
Clinical sciences