Lino-Silva Leonardo S, Domínguez-Rodríguez Jorge A, Aguilar-Romero José M, Martínez-Said Héctor, Salcedo-Hernández Rosa A, García-Pérez Leticia, Herrera-Gómez Ángel, Cuellar-Hubbe Mario
Department of Anatomic Pathology, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico.
Medicine Faculty, Mexico's National Autonomous University (UNAM), Mexico City, Mexico.
Ann Surg Oncol. 2016 Dec;23(13):4189-4194. doi: 10.1245/s10434-016-5394-x. Epub 2016 Jul 11.
The aim of this study was to analyze the clinicopathologic features of melanoma in México as the demographics of melanoma are not well known in Mexican and Latin American people.
A total of 1219 patients with cutaneous melanoma were analyzed through a retrospective database collected from a cancer referral institute, and the results were compared with developed countries.
Median age was 57 years, and 713 (58.5 %) were females. The most common melanoma subtype was acral lentiginous melanoma (ALM), which was observed in 538 (44.1 %) patients. Median Breslow thickness was 5.2 mm. Among 837 patients with complete data, the 5-year disease-specific survival (DSS) was 52.3 %. Factors associated with worse DSS on univariate analysis were Breslow thickness (p < 0.001), recurrence (p < 0.001), ulceration (p < 0.001), positive margin (p < 0.001), ALM (p = 0.001), and male sex (p = 0.001). Multivariate analysis demonstrated Breslow thickness [hazard ratio (HR) 1.45, 95 % confidence interval (CI) 1.27-1.65; p < 0.001], positive margin (HR 1.25, 95 % CI 1.03-1.57; p = 0.018), recurrence (HR 9.56, 95 % CI 6.89-9.87; p = 0.002), ALM (HR 8.07, 95 % CI 6.77-8.95; p = 0.004), and male sex (HR 1.33, 95 % CI 1.06-1.68; p = 0.013) as independent risk factors for DSS.
Our patients had worse prognosis compared with data from the US Surveillance, Epidemiology, and End Results database. We found male sex and ALM as independent risk factors for worse survival, in addition to known risk factors.
本研究旨在分析墨西哥黑色素瘤的临床病理特征,因为墨西哥人和拉丁美洲人的黑色素瘤人口统计学特征尚不为人所知。
通过从一家癌症转诊机构收集的回顾性数据库,对总共1219例皮肤黑色素瘤患者进行分析,并将结果与发达国家进行比较。
中位年龄为57岁,713例(58.5%)为女性。最常见的黑色素瘤亚型是肢端雀斑样痣黑色素瘤(ALM),538例(44.1%)患者出现该亚型。中位 Breslow 厚度为5.2mm。在837例有完整数据的患者中,5年疾病特异性生存率(DSS)为52.3%。单因素分析中与较差DSS相关的因素有 Breslow 厚度(p<0.001)、复发(p<0.001)、溃疡(p<0.001)、切缘阳性(p<0.001)、ALM(p=0.001)和男性(p=0.001)。多因素分析显示,Breslow 厚度[风险比(HR)1.45,95%置信区间(CI)1.27 - 1.65;p<0.001]、切缘阳性(HR 1.25,95%CI 1.03 - 1.57;p = 0.018)、复发(HR 9.56,95%CI 6.89 - 9.87;p = 0.002)、ALM(HR 8.07,95%CI 6.77 - 8.95;p = 0.004)和男性(HR 1.33,95%CI 1.06 - 1.68;p = 0.013)是DSS的独立危险因素。
与美国监测、流行病学和最终结果数据库的数据相比,我们的患者预后较差。除了已知的危险因素外,我们发现男性和ALM是生存较差的独立危险因素。