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皮肤恶性黑色素瘤患者社会经济地位的预后影响:一项基于人群的研究。

Prognostic impact of socioeconomic status among patients with malignant melanoma of the skin: a population-based study.

机构信息

Department of Oncology, University of Alberta, Cross Cancer Institute, Edmonton, Canada.

出版信息

J Dermatolog Treat. 2020 Sep;31(6):571-575. doi: 10.1080/09546634.2019.1657223. Epub 2019 Aug 29.

DOI:10.1080/09546634.2019.1657223
PMID:31418320
Abstract

To assess the prognostic impact of socioeconomic status (SES) on the outcome of cases with cutaneous melanoma. Novel SEER socioeconomic database has been accessed and patients with malignant melanoma of the skin (2000-2015) were reviewed. SES was evaluated through a specialized multi-dimension index and patients were classified into three groups (group 1/2/3) where group 1 has the lowest SES and group 3 has the highest SES. Kaplan-Meier survival estimates were used to evaluate the impact of SES on overall survival and multivariable Cox regression analysis was used to assess the impact of SES on melanoma-specific survival. A total of 261,076 patients with malignant melanoma of the skin were included in the current study. Among which, 44,804 patients were within group 1 SES, 84,168 patients were within group 2 SES and 132,104 patients were within group 3 SES. Kaplan-Meier survival analysis was performed, and it showed that patients with lower SES have worse overall survival ( < .001). Multivariable Cox regression analysis was subsequently performed, and it showed also that lower SES is associated with worse melanoma-specific survival (hazard ratio for group 1 versus group 3 SES: 1.361; 95% CI: 1.315-1.409;  < .001). Patients with cutaneous melanoma and lower SES have worse overall and melanoma-specific survival compared to patients with higher SES. This finding was consistent among different clinical subsets of patients according to stage, race/ethnicity, and year of diagnosis.

摘要

为了评估社会经济地位(SES)对皮肤黑色素瘤病例结局的预后影响。我们访问了新的 SEER 社会经济数据库,并回顾了皮肤恶性黑色素瘤患者(2000-2015 年)。SES 通过专门的多维指数进行评估,患者被分为三组(第 1/2/3 组),其中第 1 组 SES 最低,第 3 组 SES 最高。使用 Kaplan-Meier 生存估计来评估 SES 对总生存的影响,使用多变量 Cox 回归分析来评估 SES 对黑色素瘤特异性生存的影响。本研究共纳入 261076 例皮肤恶性黑色素瘤患者。其中,44804 例患者 SES 处于第 1 组,84168 例患者 SES 处于第 2 组,132104 例患者 SES 处于第 3 组。进行 Kaplan-Meier 生存分析,结果显示 SES 较低的患者总生存较差( < .001)。随后进行多变量 Cox 回归分析,结果也表明 SES 较低与黑色素瘤特异性生存较差相关(SES 第 1 组与第 3 组相比的危险比:1.361;95%CI:1.315-1.409; < .001)。与 SES 较高的患者相比,SES 较低的皮肤黑色素瘤患者总生存和黑色素瘤特异性生存更差。根据分期、种族/民族和诊断年份,这一发现在不同的患者临床亚组中是一致的。

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