Department of Epidemiology and Biostatistics, Key Laboratory of Cancer Prevention and Therapy, Tianjin, National Clinical Research Center of Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
J Am Acad Dermatol. 2018 May;78(5):957-963. doi: 10.1016/j.jaad.2017.12.075. Epub 2018 Jan 6.
Previous studies have found an increased risk for invasive cutaneous melanoma (CM) among those with a history of keratinocyte carcinoma (KC).
The aim of this study was to evaluate the risk of CM death after KC.
The study was based on the Health Professionals Follow-up Study. A Cox proportional hazards model was used to examine the hazard ratio (HR) of death due to CM associated with personal history of KC among the entire study population (primary analysis) and among participants with invasive CM (secondary analysis), respectively.
We documented a total of 908 participants with invasive CM over a total of 0.7 million person-years of follow-up. Among all participants, the risk for development of either lethal or nonlethal invasive CM increased for those with a history of KC. The risk for death due to melanoma based on KC history was not significantly increased, with an HR of 1.53 (95% confidence interval, 0.95-2.46). In the case-only analysis, those with a history of KC had a significantly lower risk for death due to melanoma than those with no such history (HR, 0.60; 95% confidence interval, 0.35-0.94).
Because the population covered by the Health Professionals Follow-up Study consists exclusively of male health professionals, the results of this study may not be extended to the entire population.
Personal history of KC is associated with a decreased risk for melanoma-specific death among male patients with invasive CM.
先前的研究发现，患有角化细胞癌 (KC) 的人患侵袭性皮肤黑色素瘤 (CM) 的风险增加。
本研究旨在评估 KC 后 CM 死亡的风险。
本研究基于健康专业人员随访研究。使用 Cox 比例风险模型分别在整个研究人群（主要分析）和患有侵袭性 CM 的参与者中（次要分析），检查与 KC 个人史相关的 CM 死亡的危险比 (HR)。
我们共记录了 908 名在 0.7 百万人年随访期间患有侵袭性 CM 的参与者。在所有参与者中，有 KC 病史的人发生任何致命或非致命侵袭性 CM 的风险增加。基于 KC 病史的黑色素瘤死亡风险没有显著增加，HR 为 1.53（95%置信区间，0.95-2.46）。在病例对照分析中，有 KC 病史的人死于黑色素瘤的风险明显低于没有此类病史的人（HR，0.60；95%置信区间，0.35-0.94）。
由于健康专业人员随访研究涵盖的人群仅由男性健康专业人员组成，因此本研究的结果可能不适用于整个人群。
在患有侵袭性 CM 的男性患者中，KC 个人史与黑色素瘤特异性死亡风险降低相关。
