皮肤黑色素瘤原发肿瘤溃疡：在 TNM 分期中的作用。

Primary tumour ulceration in cutaneous melanoma: its role on TNM stages.

机构信息

Institute of Oncology, Istanbul University, Istanbul.

Department of Medical Oncology, Koc University, Istanbul, Turkey.

出版信息

Jpn J Clin Oncol. 2021 Feb 8;51(2):192-198. doi: 10.1093/jjco/hyaa191.

DOI:10.1093/jjco/hyaa191

PMID:33159197

Abstract

BACKGROUND

Tumour ulceration has unfavourable prognostic factor in stage I-II melanoma. The aim of this study was to question whether tumour ulceration might predict relapse and survival in melanomas of all stages.

METHODS

A total of 911 melanoma patients were analysed.

RESULTS

The 5-year relapse-free survival rates were 50.0% for ulcerated melanomas and 75.8% for all non-ulcerated melanomas (P = 0.0001). Ulcerated melanomas had lower relapse-free survival rates than non-ulcerated melanomas in all T-stages (P = 0.0001). The relapse-free survival rates were statistically significant for T1 (P = 0.02), T3 (P = 0.01) and T4 (P = 0.004); however, T2 (P = 0.07). There were significant differences between ulcerated melanomas and non-ulcerated melanomas regarding relapse-free survival rates for both N0 (P = 0.0001) and N1 (P = 0.01) patients; poor relapse-free survival rates were found to be in association with ulcerated melanomas (P = 0.06 for N1, P = 0.04 for N2 and P = 0.8 for N3 disease). The 5- year overall survival rates were 55.3 and 81.5% for ulcerated melanomas and non-ulcerated melanomas, respectively (P = 0.0001). Ulcerated melanomas had lower overall survival rates than non-ulcerated melanomas in all T-stages; they were statistically significant for T1 (P = 0.01), T2 (P = 0.03) and T4 (P = 0.006), but not for T3 (P = 0.3). Ulceration predicted poor survival in N0 patients; however, it was not found significant although its overall survival rate was lower in node-positive patients (P = 0.09), and ulceration was a significantly poor prognostic factor only for N3 patients (P = 0.03), but not for N1 (P = 0.9) and N2 patients (P = 0.2). Furthermore, non-metastatic patients with ulcerated melanomas survived significantly less (P = 0.0001), but there were no differences in survivals between ulcerated melanoma and non-ulcerated melanoma metastatic melanoma patients (P = 0.1).

CONCLUSION

Primary tumour ulceration has been considered as a poor prognostic factor in local melanomas, but it might also have a potential for predicting survival in loco-regional and advanced melanomas.

摘要

背景

肿瘤溃疡在 I 期-II 期黑色素瘤中是一个不利的预后因素。本研究旨在探讨肿瘤溃疡是否可以预测所有分期黑色素瘤的复发和生存。

方法

分析了 911 例黑色素瘤患者。

结果

溃疡性黑色素瘤的 5 年无复发生存率为 50.0%，所有非溃疡性黑色素瘤的无复发生存率为 75.8%（P=0.0001）。在所有 T 分期中，溃疡性黑色素瘤的无复发生存率均低于非溃疡性黑色素瘤（P=0.0001）。T1 期（P=0.02）、T3 期（P=0.01）和 T4 期（P=0.004）的无复发生存率具有统计学意义；然而，T2 期（P=0.07）无复发生存率无统计学意义。N0（P=0.0001）和 N1（P=0.01）患者中，溃疡性黑色素瘤与非溃疡性黑色素瘤的无复发生存率存在显著差异；发现溃疡性黑色素瘤与不良无复发生存率相关（N1 期 P=0.06，N2 期 P=0.04，N3 期 P=0.8）。溃疡性黑色素瘤和非溃疡性黑色素瘤的 5 年总生存率分别为 55.3%和 81.5%（P=0.0001）。在所有 T 分期中，溃疡性黑色素瘤的总生存率均低于非溃疡性黑色素瘤；T1 期（P=0.01）、T2 期（P=0.03）和 T4 期（P=0.006）有统计学意义，但 T3 期（P=0.3）无统计学意义。溃疡预测 N0 患者预后不良；然而，在淋巴结阳性患者中，其总生存率较低，但无统计学意义（P=0.09），溃疡仅对 N3 患者（P=0.03）是一个显著的预后不良因素，而对 N1 患者（P=0.9）和 N2 患者（P=0.2）则不是。此外，有溃疡的非转移性黑色素瘤患者的生存率显著降低（P=0.0001），但有溃疡的黑色素瘤与无溃疡的转移性黑色素瘤患者的生存率无差异（P=0.1）。