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Abstract
Background
Given the increasing incidence in cutaneous malignant melanoma (CMM) and the recent changes in the treatment landscape, it is important to understand stage-specific overall and recurrence-free survival patterns in Europe. Despite publications such as EUROCARE-5, there is limited information on stage-specific survival for CMM in Europe.
Method
We carried out a systematic literature review to provide an up-to-date summary of stage-specific survival and recurrence-free survival patterns in patients with CMM in Europe. Studies were included if they were published in Medline during the past 12 years and included information on stage-specific survival and/or recurrence in CMM.
Results
Of the 8,749 studies identified, 26 studies were included, representing nine countries. Collectively, the studies covered a population of 152,422 patients and included data from 1978 to 2011. Randomized clinical trials and single-center observational studies comprised the most common study designs, including five large registry-based studies. Stage-specific information for survival and recurrence varied: 5-year overall survival: 95%–100% (stage I), 65%–92.8% (stage II), 41%–71% (stage III), and 9%–28% (stage IV); 5-year relapse-free survival was reported less frequently: 56% (stage II), and 28%–44% (stage III). Studies reporting survival by sentinel node (SN) status reported 5-year overall survival as 80%–95% for negative SN (stage I/II) and 35%–75% for positive SN (stage III) status; recurrence-free survival at 5 years: 76%–90% for negative and 35%–58% for positive SN status. Some studies included comparisons of survival by key patient sociodemographic characteristics, suggesting that these have a substantial influence on survival and recurrence estimates.
Conclusion
The studies identified in this review show large variations in stage-specific overall and recurrence-free survival by study type and by country. Owing to differing study designs and populations, it is difficult to make detailed comparisons. Large population-based studies that include stage-specific survival and recurrence in Europe are therefore important.
Supplementary materials
Figure S1 Search flow diagram (according to the PRISMA statement).
Abbreviation: PRISMA, Preferred Reporting Items for Systematic Reviews and Meta-Analyses.
Table S1 PRISMA systematic review reporting checklist
Table S2 Medline search command
Acknowledgments
Scientific consultancy on the study was provided by IMS Health, Sweden. This study was funded by Amgen Limited.
Disclosure
This study was supported by Amgen Limited. Johan Hansson was funded by The Swedish Cancer Society, The Radiumhemmet Research Funds, The Swedish Research Council, and The Stockholm County Council. At the time of writing, Demetris Pillas, Aliki Taylor, and Moninder Kaur were employed by Amgen Limited, and Aliki Taylor owned Amgen stock. Fernanda Costa Svedman has no conflicts of interest. Johan Hansson was acting as a consultant for IMS Health (formerly Pygargus) during the conduct of the study. Johan Hansson has received personal fees from Roche, Bristol-Myers Squibb, Novartis, and Merck, outside the submitted work. Ragnar Linder received a grant from Amgen Ltd to carry out the study to develop a report on survival after CMM in Europe. No grant was given for the manuscript development. Amgen and other pharmaceutical companies are regular clients to Pygargus/IMS Health, outside the submitted work. The authors report no other conflicts of interest in this work.