Department of Dermatology, Eberhard-Karls-University of Tübingen, Tübingen, Germany.
Center for Dermatooncology, Department of Dermatology, Eberhard-Karls-University of Tübingen, Tübingen, Germany.
J Am Acad Dermatol. 2019 May;80(5):1299-1307.e7. doi: 10.1016/j.jaad.2019.01.044. Epub 2019 Jan 29.
Melanoma incidence rates rise as people age, but the impact of aging on distant metastasis is unclear.
To investigate how timing, pattern, and extent of distant metastasis is influenced by age.
Analysis of a single-center cohort of 1457 patients of the German Central Malignant Melanoma Registry with prospectively documented follow-up. Findings were compared with those for 1682 patients from 5 different institutions. All patients presented initially with stage IA to IIC and developed distant metastasis in their further disease course.
The number of metastatic sites decreased with increasing age at melanoma diagnosis (P < .001). The rate of stage M1d disease decreased from 50.2% in patients aged 50 years or younger to 30.1% in patients older than 70 years, and the rate of stage M1b disease increased from 5.8% to 21.5%. The rate of lung metastases remained stable in all investigated age groups (P = .54). Distant metastases occurred earlier and were more synchronized in patients older than 70 years than in patients aged 50 years or younger. An age-dependent decrease in metastatic sites and stable rate of lung metastasis were found and confirmed by data on the multi-institutional cohort.
The study was not population based.
Pattern, timing, and extent of distant metastasis change as people age. These findings may be considered when treating patients with melanoma of different ages.
随着人们年龄的增长,黑色素瘤发病率上升,但衰老对远处转移的影响尚不清楚。
研究年龄对远处转移的时间、模式和范围的影响。
对德国中央恶性黑色素瘤注册中心的 1457 例前瞻性记录随访的患者进行单中心队列分析。并将结果与来自 5 个不同机构的 1682 例患者进行比较。所有患者最初表现为 IA 至 IIC 期,并在随后的疾病过程中出现远处转移。
转移性肿瘤数量随黑色素瘤诊断时年龄的增加而减少(P <.001)。M1d 期疾病的发生率从 50 岁及以下患者的 50.2%降至 70 岁以上患者的 30.1%,M1b 期疾病的发生率从 5.8%增加至 21.5%。所有研究年龄组的肺转移率保持稳定(P =.54)。70 岁以上患者的远处转移发生更早且更同步,而 50 岁及以下患者则更晚且更异步。多机构队列的数据证实了转移性肿瘤部位和肺转移率随年龄下降的趋势。
该研究不是基于人群的。
随着年龄的增长,远处转移的模式、时间和范围发生变化。在治疗不同年龄的黑色素瘤患者时,可以考虑这些发现。