Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden; Regional Cancer Center South East, University Hospital, Linköping, Sweden.
Br J Dermatol. 2015 Mar;172(3):700-6. doi: 10.1111/bjd.13483. Epub 2015 Feb 5.
Both patient survival and the proportion of patients diagnosed with thin cutaneous malignant melanoma (CMM) have been steadily rising in Sweden as in most Western countries, although the rate of improvement in survival appears to have declined in Sweden at the end of the last millennium.
To analyse the most recent trends in the distribution of tumour thickness (T category) as well as CMM-specific survival in Swedish patients diagnosed during 1997-2011.
This nationwide population-based study included 30,590 patients registered in the Swedish Melanoma Register (SMR) and diagnosed with a first primary invasive CMM during 1997-2011. The patients were followed through 2012 in the national Cause of Death Register.
Logistic and Cox regression analyses adjusting for age at diagnosis, tumour site and healthcare region were carried out. The odds ratio for being diagnosed with thicker tumours was significantly reduced (P < 0·001) and the CMM-specific survival significantly improved in men diagnosed during 2007-2011 compared with men diagnosed during 1997-2001 (hazard ratio = 0·81; 95% confidence interval 0·72-0·91; P < 0·001), while the corresponding differences for women were not significant. Women were diagnosed with significantly thicker tumours during 2002-2006 and a tendency towards decreased survival was observed compared with those diagnosed earlier (during 1997-2001) and later (during 2007-2011).
In Sweden, the CMMs of men are detected earlier over time and this seems to be followed by an improved CMM-specific survival for men. Women are still diagnosed with considerably thinner tumours and they experience a better survival than men.
在瑞典和大多数西方国家一样，患者生存率和诊断为薄型皮肤恶性黑色素瘤（CMM）的患者比例稳步上升，尽管在上个千年末期，生存率的改善速度似乎有所下降。
分析瑞典患者在 1997-2011 年间诊断的肿瘤厚度（T 分期）分布和 CMM 特异性生存的最新趋势。
这是一项全国性的基于人群的研究，纳入了 30590 名在瑞典黑色素瘤登记处（SMR）登记并在 1997-2011 年间诊断为首次原发性侵袭性 CMM 的患者。通过国家死因登记处对患者进行了 2012 年的随访。
进行了调整诊断时年龄、肿瘤部位和医疗区域的逻辑和 Cox 回归分析。与 1997-2001 年间诊断的男性相比，2007-2011 年间诊断的男性被诊断为更厚肿瘤的可能性显著降低（P < 0.001），CMM 特异性生存率显著提高（危险比=0.81；95%置信区间 0.72-0.91；P < 0.001），而女性的相应差异不显著。女性在 2002-2006 年间被诊断出的肿瘤明显更厚，与更早（1997-2001 年）和更晚（2007-2011 年）诊断的患者相比，生存率呈下降趋势。
在瑞典，男性 CMM 的检出时间随时间推移而提前，这似乎与男性 CMM 特异性生存率的提高有关。女性仍被诊断为明显更薄的肿瘤，并且她们的生存率优于男性。
