Victorian Melanoma Service, Alfred Hospital, Melbourne, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Victorian Melanoma Service, Alfred Hospital, Melbourne, Australia.
J Am Acad Dermatol. 2017 Mar;76(3):494-498.e2. doi: 10.1016/j.jaad.2016.08.009. Epub 2016 Oct 26.
Scalp melanomas have more aggressive clinicopathological features than other melanomas and mortality rates more than twice that of melanoma located elsewhere.
We sought to describe the survival of patients with scalp melanoma versus other cutaneous head and neck melanoma (CHNM), and explore a possible independent negative impact of scalp location on CHNM survival.
A retrospective cohort study was performed of all invasive primary CHNM cases seen at a tertiary referral center over a 20-year period. Melanoma-specific survival (MSS) was compared between scalp melanoma and other invasive CHNM. Multivariable Cox proportional hazards regression was performed to determine associations with survival.
On univariate analysis, patients with scalp melanoma had worse MSS than other CHNM (hazard ratio 2.22, 95% confidence interval 1.59-3.11). Scalp location was not associated with MSS in CHNM on multivariable analysis (hazard ratio 1.11, 95% confidence interval 0.77-1.61) for all tumors together, but remained independently associated with MSS for the 0.76- to 1.50-mm thickness stratum (hazard ratio 5.51, 95% confidence interval 1.55-19.59).
Disease recurrence was not assessed because of unavailable data.
The poorer survival of scalp melanoma is largely explained by greater Breslow thickness and a higher proportion of male patients.
头皮黑色素瘤比其他黑色素瘤具有更具侵袭性的临床病理特征，死亡率是其他部位黑色素瘤的两倍多。
我们旨在描述头皮黑色素瘤患者与其他头颈部皮肤黑色素瘤（CHNM）患者的生存情况，并探讨头皮位置对 CHNM 生存可能存在的独立负面影响。
对 20 年来在一家三级转诊中心就诊的所有侵袭性原发性 CHNM 病例进行回顾性队列研究。比较头皮黑色素瘤和其他侵袭性 CHNM 的黑色素瘤特异性生存率（MSS）。采用多变量 Cox 比例风险回归分析确定与生存相关的因素。
在单因素分析中，头皮黑色素瘤患者的 MSS 明显差于其他 CHNM（风险比 2.22，95%置信区间 1.59-3.11）。在多变量分析中，头皮位置与所有肿瘤的 CHNM 患者 MSS 无相关性（风险比 1.11，95%置信区间 0.77-1.61），但在 0.76-1.50mm 厚度分层中与 MSS 独立相关（风险比 5.51，95%置信区间 1.55-19.59）。
由于数据不可用，未评估疾病复发情况。
头皮黑色素瘤生存率较差主要归因于更大的 Breslow 厚度和更多的男性患者。
