Department of Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
Nat Rev Clin Oncol. 2010 Mar;7(3):148-52. doi: 10.1038/nrclinonc.2010.1. Epub 2010 Feb 9.
The number of melanoma cases in the elderly (>65 years) will rise over the coming decades, making it an important public health problem. Elderly white men are the demographic group who are at highest risk of being diagnosed with melanoma and of dying from this cancer. Among patients with melanoma, older age is recognized as an independent poor prognostic factor, but it remains unclear whether this relationship is due to a change in the biology of the disease with increasing patient age, declining host defenses, or both. Most elderly patients can have surgery to control locoregional disease, but might not be candidates for intensive biologic therapies for advanced melanoma because of comorbidities and inability to tolerate the adverse side effects of these treatments. Early detection remains an important strategy for the management of melanoma. Further research is needed to determine why older melanoma patients have a worse prognosis than their younger counterparts, even when matched for all other clinical and pathological predictors of survival outcomes.
在未来几十年，老年人（>65 岁）中黑色素瘤病例的数量将会增加，这使其成为一个重要的公共卫生问题。老年白种男性是被诊断患有黑色素瘤和死于这种癌症风险最高的人群。在黑色素瘤患者中，年龄较大被认为是独立的预后不良因素，但尚不清楚这种关系是由于随着患者年龄的增加疾病生物学的变化、宿主防御能力的下降，还是两者兼而有之。大多数老年患者可以通过手术来控制局部区域疾病，但由于合并症和无法耐受这些治疗的不良反应，他们可能不适合接受晚期黑色素瘤的强化生物治疗。早期发现仍然是黑色素瘤治疗的重要策略。需要进一步研究以确定为什么即使在与所有其他生存结果的临床和病理预测因素相匹配的情况下，老年黑色素瘤患者的预后也比年轻患者差。
