Brazilian Melanoma Group, São Paulo, São Paulo, Brazil.
JCO Glob Oncol. 2020 Apr;6:575-582. doi: 10.1200/JGO.20.00005.
National epidemiologic data on melanoma are scarce in Brazil. The current work presents final demographic, clinical, and pathologic results from the Brazilian Melanoma Group database to detail how patients with melanoma present at diagnosis.
The online database includes patients diagnosed between 1982 and 2015 and evaluated at their centers of origin between 2001 and 2016. The primary objective was to describe the demographic, clinical, and pathologic characteristics of the patients, and secondary objectives were to investigate the association between clinical and pathologic variables of interest.
A total of 1,596 patients were included. Median age was 52 years, 57% were women, and the majority were identified as white. Invasive melanoma was diagnosed in 1,297 patients, mostly localized, whereas 299 (19%) had in situ disease (TisN0M0). Only 165 patients had initial lymph node involvement. Fitzpatrick skin types I or II were slightly more frequent with in situ melanoma (73%) than with invasive disease (67%; = .054). The median Breslow thickness was 0.95 mm, Clark levels 2 and 3 comprised nearly 70% of cases, and ulceration was present in 18% of patients. The mitotic rate was significantly associated with the presence of ulceration and both vascular and perineural invasion but not with margin positivity, whereas histologic regression was associated with both intratumoral and peritumoral inflammatory infiltrates.
Despite the limitations of an observational, registry-based study, the current results provide a general profile of patients with cutaneous melanoma in Brazil at the time of diagnosis.
巴西缺乏关于黑色素瘤的国家流行病学数据。目前的工作展示了巴西黑色素瘤研究组数据库的最终人口统计学、临床和病理结果,详细说明黑色素瘤患者在诊断时的表现。
在线数据库包含 1982 年至 2015 年间诊断的患者,并在 2001 年至 2016 年期间在其原籍中心进行评估。主要目的是描述患者的人口统计学、临床和病理特征,次要目的是研究感兴趣的临床和病理变量之间的关联。
共纳入 1596 例患者。中位年龄为 52 岁,57%为女性,大多数为白人。1297 例患者诊断为侵袭性黑色素瘤,主要为局限性,299 例(19%)为原位疾病(TisN0M0)。仅有 165 例患者有初始淋巴结受累。原位黑色素瘤的 Fitzpatrick 皮肤类型 I 或 II 略多于侵袭性疾病(73%比 67%; =.054)。中位 Breslow 厚度为 0.95mm,Clark 水平 2 和 3 占近 70%的病例,18%的患者存在溃疡。有丝分裂率与溃疡、血管和神经周围侵犯的存在显著相关,但与切缘阳性无关,而组织学消退与肿瘤内和肿瘤周围炎症浸润均相关。
尽管存在观察性、基于登记的研究的局限性,但目前的结果提供了巴西在诊断时的皮肤黑色素瘤患者的一般概况。