Nunes Luiz Fernando, Mendes Gélcio L Q, Koifman Rosalina J
Brazilian National Cancer Institute, Rio de Janeiro, Brazil-Connective Bone Tissue Section.
Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
J Surg Oncol. 2018 Dec;118(7):1142-1149. doi: 10.1002/jso.25242. Epub 2018 Sep 27.
Subungual melanoma (SM) is rare. The lesions are thick at the time of diagnosis. Few studies have evaluated SM in Brazil.
The objective of this study was to investigate the factors associated with the survival of SM patients from the Brazilian National Cancer Institute.
One-hundred and fifty-seven patients diagnosed with SM were included in this study. We evaluated the epidemiologic, clinical, and histopathological data. Overall survival (OS) and relapse-free survival (RFS) curves were computed using the Kaplan-Meier method. Multivariable analyses were conducted using the Cox proportional hazard regression model.
Among the 157 patients, 87 (55.4%) were female. The median age was 68 years old. Median tumor depth was 6.0 mm. Lesions were ulcerated in 94 (59.9%). OS and RFS rates for 5 years were 61.0% and 41.8%, respectively. Median follow-up time was 28 months. The factors associated with OS were Breslow thickness and ulceration, and for RFS, they were the anatomical site, Breslow thickness, and ulceration.
This is the largest series of SM patients. The 5-year OS and RFS rates were low (61.0% and 48.2%, respectively), and the main prognostic factors for OS were Breslow thickness and ulceration.
甲下黑色素瘤（SM）较为罕见。确诊时病灶较厚。在巴西，很少有研究对甲下黑色素瘤进行评估。
本研究的目的是调查巴西国家癌症研究所甲下黑色素瘤患者生存的相关因素。
本研究纳入了157例诊断为甲下黑色素瘤的患者。我们评估了流行病学、临床和组织病理学数据。采用Kaplan-Meier方法计算总生存（OS）和无复发生存（RFS）曲线。使用Cox比例风险回归模型进行多变量分析。
157例患者中，87例（55.4%）为女性。中位年龄为68岁。肿瘤中位深度为6.0毫米。94例（59.9%）病灶发生溃疡。5年的OS率和RFS率分别为61.0%和41.8%。中位随访时间为28个月。与OS相关的因素是Breslow厚度和溃疡，与RFS相关的因素是解剖部位、Breslow厚度和溃疡。
这是最大系列的甲下黑色素瘤患者。5年的OS率和RFS率较低（分别为61.0%和48.2%），OS的主要预后因素是Breslow厚度和溃疡。
