Competitive risk analysis of prognosis in patients with primary uveal melanoma

Background The presence of competing risks suggests that the classic Cox proportional hazards model may yield biased results when assessing prognostic factors for primary uveal melanoma (PUM) patients. Objective The aim of this research is to utilize a competing risk model using the Surveillance, Epidemiology, and End Results (SEER) database in order to discover predictive factors for individuals with PUM and contrast them with the conventional Cox proportional hazards model. Methods We collected information on individuals who were diagnosed with PUM and registered in the SEER database from 2010 to 2015. The univariate analysis involved the application of the cumulative incidence function and Gray's test, while a multivariate analysis was conducted using the Fine-Gray, cause-specific (CS) and Cox proportional hazards models. Results Among the 1712 eligible patients diagnosed with PUM, 631 individuals passed away: 400 due to PUM and 231 from other causes. One-way Gray’s test indicated that seven variables significantly influenced the survival prognosis of PUM patients ( P  < 0.05). Multivariate competing risk models indicated that age, race, histologic type, AJCC stage, surgery and chemotherapy were independent predictors for cause-specific survival of