同时诊断患有黑色素瘤和肾细胞癌的患者的特征。

Characteristics of patients diagnosed with both melanoma and renal cell cancer.

机构信息

Division of Urology, Department of Surgery, Duke Cancer Institute, Duke University Medical Center, 200 Trent Drive, DUMC Box 2804, Durham, NC, 27710, USA,

出版信息

Cancer Causes Control. 2013 Nov;24(11):1925-33. doi: 10.1007/s10552-013-0267-0. Epub 2013 Jul 30.

DOI:10.1007/s10552-013-0267-0

PMID:23897487

Abstract

BACKGROUND

Patients with renal cell carcinoma (RCC) and malignant melanoma (MM) have an increased risk of additional malignancies. We identified characteristics of MM and RCC associated with a patient developing both cancers.

METHODS

A total of 147,656 cases of RCC and 225,548 of MM submitted to the Surveillance, Epidemiology, and End Results database between 1973 and 2008 were analyzed. Standardized incidence ratios (SIR) with 95 % confidence intervals (CI) were calculated for MM after RCC and vice versa. Clinical and pathological characteristics were compared between patients with RCC or MM only and with both cancers using multivariable proportional hazards and competing risks regression models.

RESULTS

Overall 1,241 patients developed both cancers. The crude incidence rates of RCC in patients with a prior MM diagnosis and vice versa were 5.2 and 9.4 per 10,000 person-years, respectively. There was an excess of MM in RCC patients (SIR 1.45, CI 1.34-1.57) and of RCC in MM patients (SIR 1.34, CI 1.25-1.43). Median years from RCC to MM diagnosis was 4.3 (2.0-7.8) and from MM to RCC 4.7(2.3-9.9). Patients with a history of MM had more papillary RCC (10.2 vs. 4.8 %, p = 0.01) and were more likely to be female (25.9 vs. 20.5 %, p < 0.001). On multivariable analyses, ocular MM was independently associated with subsequent RCC (HR 1.76 CI 1.24-2.49), as were increasing age, and male sex.

CONCLUSIONS

We confirmed a bidirectional association between RCC and MM. A history of MM was found to be associated with papillary RCC and advanced RCC. Ocular MM predicted an increased risk of RCC diagnosis. Further research is warranted into the mechanisms responsible for the association between RCC and MM.

摘要

背景

患有肾细胞癌 (RCC) 和恶性黑色素瘤 (MM) 的患者发生其他恶性肿瘤的风险增加。我们确定了与患者同时发生两种癌症相关的 MM 和 RCC 的特征。

方法

分析了 1973 年至 2008 年间向监测、流行病学和最终结果数据库提交的 147656 例 RCC 和 225548 例 MM 病例。计算了 RCC 后 MM 和反之亦然的 MM 的标准化发病率比 (SIR) 和 95%置信区间 (CI)。使用多变量比例风险和竞争风险回归模型比较仅患有 RCC 或 MM 以及同时患有两种癌症的患者的临床和病理特征。

结果

共有 1241 例患者同时患有两种癌症。先前诊断为 MM 的患者和反之亦然的 RCC 粗发病率分别为每 10000 人年 5.2 和 9.4 例。RCC 患者中 MM 过多 (SIR 1.45，CI 1.34-1.57)，MM 患者中 RCC 过多 (SIR 1.34，CI 1.25-1.43)。从 RCC 到 MM 诊断的中位时间为 4.3(2.0-7.8)，从 MM 到 RCC 为 4.7(2.3-9.9)。有 MM 病史的患者更有可能患有乳头状 RCC(10.2%对 4.8%，p = 0.01)，并且更有可能是女性(25.9%对 20.5%，p < 0.001)。多变量分析表明，眼部 MM 与随后的 RCC 独立相关(HR 1.76，CI 1.24-2.49)，年龄增长和男性也是如此。