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皮肤头颈部黑色素瘤(CHNM):一项基于人群的研究,探讨肿瘤位置对预后的影响。

Cutaneous head and neck melanoma (CHNM): A population-based study of the prognostic impact of tumor location.

机构信息

Department of Dermatology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.

Cancer Registry of Norway, Oslo, Norway.

出版信息

J Am Acad Dermatol. 2016 Nov;75(5):975-982.e2. doi: 10.1016/j.jaad.2016.06.048. Epub 2016 Aug 18.

Abstract

BACKGROUND

Most studies of cutaneous head and neck melanomas (CHNM) have reported poorer survival in CHNM compared with other sites, especially on the scalp/neck.

OBJECTIVE

We sought to compare patient and tumor characteristics between CHNM and cutaneous trunk and extremity melanomas and between CHNM locations (face/ear vs scalp/neck, anterior vs posterior), and to study prognostic factors in patients with CHNM.

METHODS

We studied all CHNM (n = 1074) from 8120 cases of cutaneous melanomas diagnosed in Norway in 2008 to 2012.

RESULTS

Compared with cutaneous trunk and extremity melanomas, CHNM were more frequently found in men, more often nodular and lentigo maligna cutaneous melanomas, and diagnosed at higher T stage (P ≤ .01). CHNM located on posterior sites were diagnosed at significantly higher T stage, and were significantly more often diagnosed with ulceration and at more advanced stage compared with CHNM located on anterior sites (P < .001). T stage and clinical stage were the only significant prognostic factors for melanoma-specific and overall death in the multivariable analysis (P < .001).

LIMITATIONS

Low number of cases and the relatively high frequency of missing values are limitations.

CONCLUSION

More advanced CHNM were diagnosed on posterior compared with anterior locations, but location was not a significant prognostic factor for cutaneous melanoma-specific or overall death in the multivariable models.

摘要

背景

大多数头颈部皮肤黑色素瘤(CHNM)的研究报告显示,与其他部位相比,CHNM 的生存率较差,尤其是头皮/颈部。

目的

我们旨在比较 CHNM 与皮肤躯干和四肢黑色素瘤患者和肿瘤特征,以及 CHNM 部位(面部/耳部与头皮/颈部、前/后)之间的差异,并研究 CHNM 患者的预后因素。

方法

我们研究了 2008 年至 2012 年在挪威诊断的 8120 例皮肤黑色素瘤中所有的 CHNM(n=1074)。

结果

与皮肤躯干和四肢黑色素瘤相比,CHNM 更常见于男性,更常为结节性和恶性雀斑样黑色素瘤,且诊断时 T 分期更高(P≤.01)。位于后部的 CHNM 诊断时 T 分期显著更高,与位于前部的 CHNM 相比,溃疡和更晚期的发生率显著更高(P<.001)。在多变量分析中,T 分期和临床分期是黑色素瘤特异性和总死亡的唯一显著预后因素(P<.001)。

局限性

病例数量较少且缺失值频率相对较高是本研究的局限性。

结论

与前部相比,后部诊断出的 CHNM 更晚期,但在多变量模型中,部位不是黑色素瘤特异性或总死亡的显著预后因素。

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