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台湾地区的恶性黑色素瘤:181例病例的预后研究

Malignant melanoma in Taiwan: a prognostic study of 181 cases.

作者信息

Chang John Wen-Cheng, Yeh Kun-Yun, Wang Cheng-Hsu, Yang Tsai-Shen, Chiang Hseui-Fong, Wei Fu-Chan, Kuo Tseng-Tong, Yang Chih-Hsun

机构信息

Division of Haematology-Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.

出版信息

Melanoma Res. 2004 Dec;14(6):537-41. doi: 10.1097/00008390-200412000-00016.

Abstract

This study was performed to determine the characteristics and clinical outcome of patients with cutaneous malignant melanoma in Taiwan. The medical records of patients with primary cutaneous melanoma between 1992 and 2001 at Chang Gung Memorial Hospital (CGMH) were retrieved from the cancer registry. Survival was analysed by the Kaplan-Meier method. Univariate and multivariate analyses of factors associated with survival were performed using the Cox proportional hazard model. One hundred and eighty-one cases were retrieved from the cancer registry of CGMH. The male to female ratio was 1 : 1.13. The most common age of onset was the sixth decade. The median age of onset was 61 years (2-95 years). There were 105 cases (58%) of acral lentiginous melanoma (ALM), 55 cases (30.4%) of nodular melanoma (NM), 19 cases (10.5%) of superficial spreading melanoma (SSM) and two cases (1.1%) of lentigo maligna melanoma. The median survival of the 181 patients was 3.71 years, and the 5-year survival rate was 45.63%. Five-year survival rates of patients with stages I, II, III and IV disease were 84.39%, 56.03%, 34.7% and 0%, respectively. Sex, Breslow thickness, Clark's level, pathological type and age were significant prognostic factors. There were no survival differences between ALM and NM. Both ALM and NM were associated with a poor prognosis when compared with SSM. In conclusion, ALM is the most common type of cutaneous malignant melanoma in Taiwan. The prognostic factors in Taiwan are similar to those in melanoma-prevalent countries.

摘要

本研究旨在确定台湾皮肤恶性黑色素瘤患者的特征及临床结局。从长庚纪念医院(CGMH)癌症登记处检索了1992年至2001年间原发性皮肤黑色素瘤患者的病历。采用Kaplan-Meier法分析生存率。使用Cox比例风险模型对与生存相关的因素进行单因素和多因素分析。从CGMH癌症登记处检索到181例病例。男女比例为1:1.13。最常见的发病年龄为第六个十年。发病年龄中位数为61岁(2 - 95岁)。肢端雀斑样痣黑色素瘤(ALM)105例(58%),结节性黑色素瘤(NM)55例(30.4%),浅表扩散性黑色素瘤(SSM)19例(10.5%),恶性雀斑样痣黑色素瘤2例(1.1%)。181例患者的中位生存期为3.71年,5年生存率为45.63%。I、II、III和IV期疾病患者的5年生存率分别为84.39%、56.03%、34.7%和0%。性别、Breslow厚度、Clark分级、病理类型和年龄是显著的预后因素。ALM和NM之间无生存差异。与SSM相比,ALM和NM均与预后不良相关。总之,ALM是台湾最常见的皮肤恶性黑色素瘤类型。台湾的预后因素与黑色素瘤高发国家相似。

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