Translational Research Institute, UQ Diamantina Institute, The University of Queensland, Woolloongabba, Qld, Australia.
Experimental Dermatology Group, UQ Centre for Clinical Research, The University of Queensland, Herston, Qld, Australia.
J Eur Acad Dermatol Venereol. 2015 Aug;29(8):1457-66. doi: 10.1111/jdv.12972. Epub 2015 Feb 17.
Among women, pregnancy-associated melanomas may have a poorer prognosis than other melanomas, but evidence is inconsistent. We conducted a systematic review and meta-analysis to assess the effect on melanoma outcome of a coinciding pregnancy. The objective of the study was to conduct a systematic review and meta-analysis of risk of death from, or recurrence of, pregnancy-associated melanomas compared with other melanomas in women of reproductive age. Cochrane (1996-2013), MEDLINE (1950-2013), EMBASE (1966-2013), CINAHL (1982-2013), and PUBMED (1951-2013) databases were searched for studies assessing the risk of death and recurrence in pregnancy-associated melanomas. Eligible studies investigated melanoma outcomes in women with pregnancy-associated melanomas (diagnosed during pregnancy or in 12 months following pregnancy), included a comparison group and reported measures of risk of melanoma death or disease-free survival. Eligible study designs were cohort studies of women of childbearing age with confirmed diagnoses of cutaneous melanoma. Individual study effect estimates were pooled using the weighted average method. Studies that did not report a quantitative estimate were summarized narratively. Of 304 citations identified, 14 studies met the inclusion criteria, with assessed outcomes being melanoma death (7), recurrence (3), or both (4). Pooled estimates of mortality risk from four studies showed increased risk of melanoma death after adjustment for patient age and stage of melanoma (pHR 1.56, 95% CI 1.23-1.99) for pregnancy-associated melanoma compared with other melanomas. Based on limited quantitative evidence, pregnancy-associated melanomas appear to have poorer outcomes than other melanomas.
在女性中，妊娠相关性黑色素瘤的预后可能比其他黑色素瘤差，但证据并不一致。我们进行了系统评价和荟萃分析，以评估妊娠与黑色素瘤结局的相关性。本研究的目的是对生育年龄女性的妊娠相关性黑色素瘤与其他黑色素瘤的死亡或复发风险进行系统评价和荟萃分析。Cochrane（1996-2013）、MEDLINE（1950-2013）、EMBASE（1966-2013）、CINAHL（1982-2013）和 PUBMED（1951-2013）数据库均被用于检索评估妊娠相关性黑色素瘤死亡和复发风险的研究。纳入的研究评估了妊娠相关性黑色素瘤（妊娠期间或妊娠后 12 个月内诊断）女性的黑色素瘤结局，包括一个对照组，并报告了黑色素瘤死亡或无病生存风险的衡量指标。合格的研究设计是对确诊为皮肤黑色素瘤的生育年龄女性的队列研究。使用加权平均法汇总个体研究的效应估计值。未报告定量估计值的研究进行了叙述性总结。在 304 条引用文献中，有 14 项研究符合纳入标准，评估的结果为黑色素瘤死亡（7 项）、复发（3 项）或两者兼有（4 项）。四项研究的黑色素瘤死亡风险的汇总估计值显示，与其他黑色素瘤相比，妊娠相关性黑色素瘤在调整了患者年龄和黑色素瘤分期后，黑色素瘤死亡的风险增加（调整后危险比 1.56，95%置信区间 1.23-1.99）。基于有限的定量证据，妊娠相关性黑色素瘤的结局似乎比其他黑色素瘤差。
