UQ Diamantina Institute, Translational Research Institute, The University of Queensland, Woolloongabba, Qld, Australia.
Oncogenomics, QIMR Berghofer Medical Research Institute, Herston, Qld, Australia.
J Eur Acad Dermatol Venereol. 2015 Nov;29(11):2120-7. doi: 10.1111/jdv.13144. Epub 2015 Apr 10.
A substantial number of melanoma patients will develop multiple primary melanomas (MPM). Currently, little is known about the impact of MPM on survival.
We aimed to determine whether melanoma survival is worse for patients with MPM compared to those with a single invasive primary melanoma (SPM).
A cohort study was conducted. Patients were sourced from an Australian population, with follow-up information collected retrospectively from registry data. Melanoma-specific survival analysis was performed to find associated variables after adjustment for known prognostic factors, using four different models, each selecting a different index melanoma lesion.
1068 stage I and II melanoma patients were followed up for a median of 24.4 years. MPM was found in 17.8% of the cohort (190 patients), more likely among males and older age groups. Other clinicopathological parameters were similar between the MPM and SPM (878 patients) cohorts. After adjustment for age, sex and Breslow thickness, MPM was a hazard for death from melanoma, across all models, reaching significance when considering the last invasive lesion as the index melanoma (HR = 2.76, P = 0.017).
Patients with multiple invasive lesions seem more at risk of death from melanoma, independent of known prognostic factors.
大量黑色素瘤患者会发展出多个原发性黑色素瘤（MPM）。目前，对于 MPM 对生存的影响知之甚少。
我们旨在确定与单发浸润性原发性黑色素瘤（SPM）相比，MPM 是否会导致黑色素瘤患者的生存状况更差。
进行了一项队列研究。患者来自澳大利亚人群，通过从登记处数据中回顾性收集随访信息。使用四种不同的模型进行黑色素瘤特异性生存分析，以在调整已知预后因素后找到相关变量，每个模型选择不同的索引黑色素瘤病变。
1068 例 I 期和 II 期黑色素瘤患者中位随访 24.4 年。该队列中发现 17.8%（190 例）存在 MPM，男性和年龄较大的患者更常见。MPM 和 SPM（878 例）队列之间的其他临床病理参数相似。在调整年龄、性别和 Breslow 厚度后，MPM 是所有模型中黑色素瘤死亡的危险因素，当考虑最后一个浸润性病变作为索引黑色素瘤时，达到显著水平（HR=2.76，P=0.017）。
多个浸润性病变的患者似乎更有死于黑色素瘤的风险，这独立于已知的预后因素。
