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基于犹他州监测、流行病学和最终结果数据(1973-2011 年),多发性与单发性黑色素瘤患者的生存情况相似。

Similar survival of patients with multiple versus single primary melanomas based on Utah Surveillance, Epidemiology, and End Results data (1973-2011).

机构信息

Department of Dermatology, University of Utah Health Sciences Center, Salt Lake City, Utah; Department of Oncological Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah; Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah.

Department of Medicine, University of Utah Health Sciences Center, Salt Lake City, Utah.

出版信息

J Am Acad Dermatol. 2018 Aug;79(2):238-244. doi: 10.1016/j.jaad.2018.02.055. Epub 2018 Mar 1.

Abstract

BACKGROUND

Survival data are mixed comparing patients with multiple primary melanomas (MPM) to those with single primary melanomas (SPM).

OBJECTIVES

We compared MPM versus SPM patient survival using a matching method that avoids potential biases associated with other analytic approaches.

METHODS

Records of 14,138 individuals obtained from the Surveillance, Epidemiology, and End Results registry of all melanomas diagnosed or treated in Utah between 1973 and 2011 were reviewed. A single matched control patient was selected randomly from the SPM cohort for each MPM patient, with the restriction that they survived at least as long as the interval between the first and second diagnoses for the matched MPM patient.

RESULTS

Survival curves (n = 887 for both MPM and SPM groups) without covariates showed a significant survival disadvantage for MPM patients (chi-squared 39.29, P < .001). However, a multivariate Cox proportional hazards model showed no significant survival difference (hazard ratio 1.07, P = .55). Restricting the multivariate analysis to invasive melanomas also showed no significant survival difference (hazard ratio 0.99, P = .96).

LIMITATIONS

Breslow depth, ulceration status, and specific cause of death were not available for all patients.

CONCLUSIONS

Patients with MPM had similar survival times as patients with SPM.

摘要

背景

比较多发性原发性黑色素瘤(MPM)患者和单发性原发性黑色素瘤(SPM)患者的生存数据结果不一。

目的

我们采用一种匹配方法来比较 MPM 和 SPM 患者的生存情况,该方法可以避免其他分析方法可能存在的偏倚。

方法

回顾了 1973 年至 2011 年间在犹他州诊断或治疗的所有黑色素瘤患者的监测、流行病学和最终结果登记处的 14138 例患者的记录。从 SPM 队列中为每位 MPM 患者随机选择一名单一匹配的对照患者,限制条件是他们的生存时间至少与匹配 MPM 患者的两次诊断之间的间隔一样长。

结果

无协变量的生存曲线(MPM 和 SPM 组均为 n=887)显示 MPM 患者的生存明显处于劣势(卡方检验 39.29,P<.001)。然而,多变量 Cox 比例风险模型显示无显著生存差异(风险比 1.07,P=.55)。将多变量分析仅限于侵袭性黑色素瘤也未显示出显著的生存差异(风险比 0.99,P=.96)。

局限性

并非所有患者均提供 Breslow 深度、溃疡状态和具体死因。

结论

MPM 患者的生存时间与 SPM 患者相似。

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