Lindegård B
Department of Social Medicine and Clinical Epidemiology, University of Gothenburg, Västra Frölunda, Sweden.
Biomed Pharmacother. 1990;44(10):495-501. doi: 10.1016/0753-3322(90)90169-a.
Among almost all cases of death from cutaneous malignant melanoma in Sweden during the 5-year observation period of 1982-86 (n = 1406), 58.5% were male. For both sexes, considered together, 80.5% were aged greater than 49 yr at the time of death; 62.9% aged greater than 59 yr, and 36.7% aged greater than 69 yr. Disease fatality, assessed as the sex and age-specific mortality between 1982 and 1986 in proportion to the age and sex-specific incidence in 1977 and 1982, increased significantly (P less than 0.001) with age in both sexes, in terms of distributional heterogeneity. Likewise, in both sexes, disease fatality was higher (P less than 0.025) in the area of Sweden north of the N 60 degrees latitude line rather than south of it. As it is a crucial measure of treatment efficacy in cutaneous malignant melanoma, case fatality deserves more attention in future epidemiologic research than it has received to-date. In this context, a revision of the criteria for histopathological "malignancy" at initial treatment against empirical data on the outcome quoad vitam is warranted.
在1982 - 1986年这5年观察期内瑞典几乎所有皮肤恶性黑色素瘤死亡病例（n = 1406）中，58.5%为男性。综合考虑两性情况，80.5%的死者死亡时年龄大于49岁；62.9%年龄大于59岁，36.7%年龄大于69岁。疾病病死率按1982年至1986年按性别和年龄划分的死亡率与1977年和1982年按年龄和性别划分的发病率之比来评估，就分布异质性而言，两性的病死率均随年龄显著增加（P < 0.001）。同样，在瑞典，北纬60度线以北地区的疾病病死率高于（P < 0.025）该线以南地区。由于病死率是皮肤恶性黑色素瘤治疗效果的关键衡量指标，在未来的流行病学研究中，病死率应比迄今受到更多关注。在此背景下，有必要根据关于生存结果的实证数据，修订初始治疗时组织病理学“恶性”的标准。
