成人巨大色素痣（GPN）中侵袭性恶性黑色素瘤（MM）的特征、治疗和生存：来自国家癌症数据库（NCDB）的 976 例病例。

Characteristics, treatment, and survival of invasive malignant melanoma (MM) in giant pigmented nevi (GPN) in adults: 976 cases from the National Cancer Data Base (NCDB).

机构信息

Baylor College of Medicine, Houston, Texas.

Department of Surgery, Abington Hospital-Jefferson Health, Abington, Pennsylvania.

出版信息

J Am Acad Dermatol. 2016 Jun;74(6):1128-34. doi: 10.1016/j.jaad.2016.01.024. Epub 2016 Feb 19.

DOI:10.1016/j.jaad.2016.01.024

PMID:26899200

Abstract

BACKGROUND

Malignant melanoma (MM) arising in a giant pigmented nevus (GPN) is a rare disease in adults with no large series published to our knowledge.

OBJECTIVE

We sought to describe the characteristics, treatment, and survival of MM in GPN for adults.

METHODS

Adults with invasive MM in GPN (n = 976) reported to the National Cancer Data Base from 1998 to 2012 were evaluated for patient and tumor characteristics, treatment, and survival. For comparison, data from adults with invasive superficial spreading melanoma (SSM) (n = 111,870) and nodular melanoma (n = 35,962) were used.

RESULTS

Compared with patients with SSM, patients with MM in GPN had a thicker Breslow depth, more positive lymph nodes, and distant metastasis more frequently. Multivariate analysis identified age older than 65 years, Breslow thickness greater than 2 mm, presence of ulceration, presence of distant metastasis, and positive margins as independent predictors of survival in patients with MM in GPN. At all stages, having MM in GPN has similar overall survival compared with SSM.

LIMITATIONS

The study is retrospective and registry-based.

CONCLUSIONS

Invasive MM in GPN occurs in adults, with overall survival similar to SSM. Clinicians should be aware of the continued risk of MM in adults with GPN with low threshold for biopsy.

摘要

背景

成人中源于巨大色素痣（GPN）的恶性黑色素瘤（MM）是一种罕见疾病，据我们所知，尚无大型系列报道。

目的

我们旨在描述成人 GPN 中 MM 的特征、治疗和生存情况。

方法

从 1998 年至 2012 年，国家癌症数据库报告了 976 例 GPN 中侵袭性 MM 的成年患者，评估了患者和肿瘤特征、治疗和生存情况。为了进行比较，还使用了 111870 例侵袭性浅表扩散性黑色素瘤（SSM）和 35962 例结节性黑色素瘤成年患者的数据。

结果

与 SSM 患者相比，GPN 中 MM 患者的 Breslow 深度更深，阳性淋巴结更多，远处转移更常见。多变量分析确定年龄大于 65 岁、Breslow 厚度大于 2mm、溃疡、远处转移和阳性切缘是 GPN 中 MM 患者生存的独立预测因素。在所有分期，GPN 中 MM 的总生存率与 SSM 相似。