Sandru A, Voinea S, Panaitescu E, Blidaru A
Department of Surgical Oncology, "Carol Davila" University of Medicine and Pharmacy; "Alexandru Trestioreanu" Oncologic Institute, Bucharest.
Department of Medical Informatics and Biostatistics, "Carol Davila" University of Medicine and Pharmacy, Bucharest.
J Med Life. 2014 Oct-Dec;7(4):572-6.
Malignant melanoma (MM) is the cutaneous neoplasia with the greatest mortality rates and one of the malignancies with the highest potential of dissemination. The prognosis of patients with metastatic MM is grim, with a 5-years survival rate between 5-19%, and is dictated by the location and the number of metastases.
We aimed to estimate the survival of patients with metastatic MM from our study and find out if the metastasis' location influences survival.
Between 2008 and 2013, 155 patients with cutaneous MM were diagnosed in our clinic. All the patients were staged according to 2009 AJCC staging system. The median follow-up period was of 24 months. Survival was calculated by using the Kaplan-Meier method with a confidence level of 95%. 40.5% of the patients developed metastases in different organs, especially the brain. 80.6% of those with metastases died during the study. The median overall survival, estimated for the entire group of patients who developed metastases, was of 5.3 months.
The influence of metastases distribution on the overall survival was examined and it was noticed that there were statistically significant differences between the risks of death of various groups of patients, depending on metastasis topography. Thus, the death probability of a patient with brain metastases is twice that of a patient with digestive metastasis, about 7 times higher than that of a patient with lung metastasis (p=0.0004) and 12 times higher than the death risk of a patient with extra-regional lymph nodes or subcutaneous metastasis (p=0.0000).
恶性黑色素瘤(MM)是死亡率最高的皮肤肿瘤,也是最具播散潜力的恶性肿瘤之一。转移性MM患者的预后严峻,5年生存率在5%至19%之间,且取决于转移灶的位置和数量。
我们旨在评估本研究中转移性MM患者的生存率,并确定转移灶位置是否影响生存率。
2008年至2013年期间,我们诊所诊断出155例皮肤MM患者。所有患者均根据2009年美国癌症联合委员会(AJCC)分期系统进行分期。中位随访期为24个月。采用Kaplan-Meier方法计算生存率,置信水平为95%。40.5%的患者在不同器官发生转移,尤其是脑转移。发生转移的患者中有80.6%在研究期间死亡。对所有发生转移的患者组估计的中位总生存期为5.3个月。
研究了转移灶分布对总生存期的影响,发现根据转移灶部位不同,各组患者的死亡风险存在统计学显著差异。因此,脑转移患者的死亡概率是消化转移患者的两倍,约为肺转移患者的7倍(p=0.0004),比区域外淋巴结或皮下转移患者的死亡风险高12倍(p=0.0000)。