根据美国癌症联合委员会第 8 版，无疾病生存患者的薄型黑色素瘤。

Disease-Free Survival for Patients with Thin Melanomas according to the American Joint Committee on Cancer 8th Edition.

机构信息

Dermatology Department, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain,

Research Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife, Spain,

出版信息

Dermatology. 2019;235(4):334-339. doi: 10.1159/000499652. Epub 2019 May 21.

DOI:10.1159/000499652

PMID:31112971

Abstract

BACKGROUND

The recently implemented AJCC 8th edition TNM staging system for malignant melanoma (MM) changed the definition for T1a and T1b tumours.

OBJECTIVES

To analyse differences in disease-free survival (DFS) among patients with thin MM staged according to both AJCC 7th and 8th editions.

METHODS

An observational study including 285 patients with cutaneous thin MM (thickness ≤1 mm). Cases were staged as T1a and T1b using both 7th and 8th editions. Neither regional nor visceral diseases were present at diagnosis. DFS curves were generated according to the Kaplan-Meier method.

RESULTS

An 8% shift of patients from a T1a towards a T1b stage group was observed after applying the AJCC 8th edition. According to this 8th edition, DFS for T1a patients was significantly longer than for T1b patients (log-rank test; p = 0.005); 5-year DFS for T1a and T1b was 100 and 95%, respectively (Wilcoxon test; p = 0.002). According to the AJCC 7th edition, DFS did not significantly differ for T1a and T1b patients; 5-year DFS for T1a and T1b was 99 and 97%, respectively (p > 0.05).

CONCLUSIONS

The AJCC 8th edition seems to be a better tool for staging thin melanomas.

摘要

背景

最近实施的 AJCC 第 8 版黑色素瘤（MM）TNM 分期系统改变了 T1a 和 T1b 肿瘤的定义。

目的

分析根据 AJCC 第 7 版和第 8 版分期的薄型 MM 患者无病生存（DFS）的差异。

方法

一项观察性研究纳入了 285 例皮肤薄型 MM（厚度≤1mm）患者。使用第 7 版和第 8 版分期，将病例分为 T1a 和 T1b。诊断时均无区域性或内脏疾病。根据 Kaplan-Meier 方法生成 DFS 曲线。

结果

应用 AJCC 第 8 版后，有 8%的患者从 T1a 期转移到 T1b 期。根据第 8 版，T1a 患者的 DFS 明显长于 T1b 患者（对数秩检验；p=0.005）；T1a 和 T1b 的 5 年 DFS 分别为 100%和 95%（Wilcoxon 检验；p=0.002）。根据 AJCC 第 7 版，T1a 和 T1b 患者的 DFS 无显著差异；T1a 和 T1b 的 5 年 DFS 分别为 99%和 97%（p>0.05）。