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儿童黑色素瘤:一项基于人群的35年回顾

Pediatric Melanoma: A 35-year Population-based Review.

作者信息

Dean Paige H, Bucevska Marija, Strahlendorf Caron, Verchere Cynthia

机构信息

Division of Plastic Surgery, British Columbia Children's Hospital, Vancouver, BC, Canada; Department of Surgery, University of British Columbia, Vancouver, BC, Canada; Division of Oncology/Hematology/BMT, BC Children's Hospital and BC Women's Hospital & Health Centre, Vancouver, BC, Canada; and Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.

出版信息

Plast Reconstr Surg Glob Open. 2017 Mar 9;5(3):e1252. doi: 10.1097/GOX.0000000000001252. eCollection 2017 Mar.

Abstract

BACKGROUND

Melanoma is a rare neoplasm in the pediatric population. Recent publications suggest a possible increase in incidence over the past few decades. The purpose of this study was to analyze trends in pediatric patients diagnosed with malignant melanoma in British Columbia (BC) in the past 35 years.

METHODS

A retrospective review was performed. All patients in BC diagnosed with melanoma before 18 years of age from 1979 to 2014 were included. Patient demographics, melanoma description, treatment details, and survival data were collected.

RESULTS

Seventy-eight subjects were identified for the study. Patients were equally distributed by sex. Sixty-one (78%) of the subjects were diagnosed in the postpubertal age (≥12 years old). The most common sites of occurrence were the extremities (n = 33) and the trunk (n = 27), with the location on the trunk showing the highest mortality rate (22%). All patients were surgically treated and some had additional chemotherapy (12) and/or radiotherapy (12). Fatal outcome was recorded in 12 of the 78 subjects, 10 of whom had postpubertal diagnosis. The average time from date of diagnosis to date of death was 9.3 years.

CONCLUSIONS

The incidence of melanoma in the pediatric population remains exceedingly rare: less than 2.5 per million children younger than 18 years. The diagnosis is rarely made before puberty; the incidence is equal in males and females and has not changed over a 35-year time period in BC. Our study shows 85% survival with the majority of patients having had surgical excision only.

摘要

背景

黑色素瘤在儿童群体中是一种罕见的肿瘤。近期的出版物表明在过去几十年中其发病率可能有所上升。本研究的目的是分析过去35年中不列颠哥伦比亚省(BC)诊断为恶性黑色素瘤的儿科患者的趋势。

方法

进行了一项回顾性研究。纳入了1979年至2014年间BC省所有18岁之前被诊断为黑色素瘤的患者。收集了患者的人口统计学数据、黑色素瘤描述、治疗细节和生存数据。

结果

该研究共纳入78名受试者。患者按性别均匀分布。61名(78%)受试者在青春期后(≥12岁)被诊断。最常见的发病部位是四肢(n = 33)和躯干(n = 27),躯干部位的死亡率最高(22%)。所有患者均接受了手术治疗,部分患者还接受了额外的化疗(12例)和/或放疗(12例)。78名受试者中有12例出现致命结局,其中10例在青春期后被诊断。从诊断日期到死亡日期的平均时间为9.3年。

结论

儿童群体中黑色素瘤的发病率仍然极其罕见:每百万18岁以下儿童中不到2.5例。青春期前很少做出诊断;男性和女性的发病率相等,且在BC省35年的时间里没有变化。我们的研究表明85%的患者存活,大多数患者仅接受了手术切除。

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