Mandalà Mario, Imberti Gian Lorenzo, Piazzalunga Dario, Belfiglio Maurizio, Lucisano Giuseppe, Labianca Roberto, Marchesi Lorenzo, Merelli Barbara, Robone Silvana, Poletti Paola, Milesi Laura, Tondini Carlo
Unit of Medical Oncology, Ospedali Riuniti Bergamo, Largo Barozzi 1, Bergamo, Italy.
Mayo Clin Proc. 2011 Feb;86(2):113-9. doi: 10.4065/mcp.2010.0671.
To investigate the influence of socioeconomic status (SES) on Breslow thickness, disease-free survival, and overall survival in patients with stage I-II primary cutaneous melanoma (PCM).
The study consists of all consecutive patients who were diagnosed as having PCM and were treated and followed up at our hospital between November 1, 1998, and July 31, 2009. Pathologic and sociodemographic characteristics of the patients were obtained. We categorized SES into 3 levels: low (manual employees and skilled/unskilled workers, including farmers, with primary education level), middle (nonmanual employees and clerks with middle education level), and high (professionals, executives, administrators, and entrepreneurs with tertiary education).
A total of 1443 consecutive patients were evaluated. In a multivariate logistic regression analysis, sex (female vs male: odds ratio [OR], 1.37; 95% confidence interval [CI], 1.08-1.75), SES (high vs middle: OR, 1.27; 95% CI, 0.96-1.69; high vs low: OR, 1.73; 95% CI, 1.26-2.38), age (<60 vs ≥60 years: OR, 1.35; 95% CI, 1.03-1.78), and family context (single vs living with relatives: OR, 1.37; 95% CI, 0.97-1.94) were the strongest correlates of Breslow thickness. Compared with high SES, the risk of melanoma-related death, adjusted for age and sex, was 7 times higher (hazard ratio, 7.44; 95% CI, 3.27-16.93) and almost 2 times higher (hazard ratio, 1.88; 95% CI, 1.04-3.39) in patients with low SES living alone or living with relatives, respectively.
In patients with PCM, low SES is associated with thicker melanoma and a poorer clinical outcome.
探讨社会经济地位（SES）对Ⅰ-Ⅱ期原发性皮肤黑色素瘤（PCM）患者Breslow厚度、无病生存期和总生存期的影响。
本研究纳入了1998年11月1日至2009年7月31日期间在我院诊断为PCM并接受治疗和随访的所有连续患者。获取患者的病理和社会人口学特征。我们将SES分为3个水平：低（体力劳动者以及熟练/非熟练工人，包括农民，小学教育水平）、中（非体力劳动者以及初中教育水平的职员）和高（受过高等教育的专业人员、高管、管理人员和企业家）。
共评估了1443例连续患者。在多因素逻辑回归分析中，性别（女性与男性：比值比[OR]，1.37；95%置信区间[CI]，1.08-1.75）、SES（高与中：OR，1.27；95% CI，0.96-1.69；高与低：OR，1.73；95% CI，1.26-2.38）、年龄（<60岁与≥60岁：OR，1.35；95% CI，1.03-1.78）以及家庭情况（单身与与亲属同住：OR，1.37；95% CI，0.97-1.94）是与Breslow厚度最强的相关因素。与高SES相比，在单独生活或与亲属同住的低SES患者中，经年龄和性别调整后，黑色素瘤相关死亡风险分别高7倍（风险比，7.44；95% CI，3.27-16.93）和近2倍（风险比，1.88；95% CI，1.04-3.39）。
在PCM患者中，低SES与黑色素瘤厚度增加及临床结局较差相关。
