De Giorgi Vincenzo, Grazzini Marta, Benemei Silvia, Marchionni Niccolò, Geppetti Pierangelo, Gandini Sara
aDepartment of Dermatology bDepartment of Preclinical and Clinical Pharmacology cDepartment of Geriatric Cardiology and Medicine, University of Florence, University Hospital, Florence dDivision of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
Melanoma Res. 2017 Jun;27(3):268-270. doi: 10.1097/CMR.0000000000000317.
Previous observational studies have reported the protective effect of β-blockers on the progression of different types of cancers. In 2011, we published a prospective study, including patients with histologically confirmed malignant melanoma in stage II-IIIA. In total, 25% of them reported previous use of β-blockers that were administered at any time for any other diseases. After a median follow-up of 2.5 years, 34% of the patients in the untreated group showed disease progression. In contrast, only 3% of the patients in the treated group showed progression. We report the findings obtained in the same cohort after a longer period of β-blocker therapy and follow-up (8 years). We prospectively reviewed data of the patients enrolled in the original prospective study. Disease progression was assessed by evaluating the presence of lymphatic, in-transit or visceral metastases. Deaths by any cause and deaths because of melanoma were recorded. A multivariate Cox proportional hazards model was used to evaluate the effect of β-blocker use on disease-free survival and overall survival, adjusting for significant confounders. After a median follow-up of 8 years and a median duration of β-blocker use of 7.6 years, 45% of the patients in the untreated group and 30% of the patients in the treated group showed disease progression. Notably, in the untreated group 35% patients died from melanoma and only 17% patients died from melanoma in the treated group. Results of this hospital-based prospective cohort study with a median follow-up of 8 years confirmed our previous results that the use of β-blockers significantly reduced the risk of recurrence and mortality in melanoma patients.
以往的观察性研究报告了β受体阻滞剂对不同类型癌症进展的保护作用。2011年，我们发表了一项前瞻性研究，纳入了组织学确诊为II-IIIA期恶性黑色素瘤的患者。其中，总共25%的患者报告曾因其他疾病在任何时间使用过β受体阻滞剂。经过2.5年的中位随访，未治疗组中34%的患者出现疾病进展。相比之下，治疗组中只有3%的患者出现进展。我们报告了在更长时间的β受体阻滞剂治疗和随访（8年）后同一队列中获得的结果。我们对最初前瞻性研究中纳入的患者数据进行了前瞻性回顾。通过评估是否存在淋巴、移行或内脏转移来评估疾病进展情况。记录任何原因导致的死亡以及因黑色素瘤导致的死亡。使用多变量Cox比例风险模型来评估使用β受体阻滞剂对无病生存期和总生存期的影响，并对显著混杂因素进行校正。经过8年的中位随访以及β受体阻滞剂使用的中位时长为7.6年，未治疗组中45%的患者和治疗组中30% 的患者出现疾病进展。值得注意的是，未治疗组中有35%的患者死于黑色素瘤，而治疗组中只有17% 的患者死于黑色素瘤。这项基于医院的前瞻性队列研究中位随访8年结果证实了我们之前的结果，即使用β受体阻滞剂可显著降低黑色素瘤患者的复发风险和死亡率。
