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,
Dermatology. 2019;235(4):334-339. doi: 10.1159/000499652. Epub 2019 May 21.
The recently implemented AJCC 8th edition TNM staging system for malignant melanoma (MM) changed the definition for T1a and T1b tumours.
To analyse differences in disease-free survival (DFS) among patients with thin MM staged according to both AJCC 7th and 8th editions.
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.
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).
The AJCC 8th edition seems to be a better tool for staging thin melanomas.
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。
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。
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。
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）。
AJCC 第 8 版似乎是分期薄型黑色素瘤的更好工具。
