Department of Hand and Microvascular Surgery.
Department of Spine Surgery, The 2nd Clinical Medical College of Jinan University, Shenzhen People's Hospital, Shenzhen, Guangdong, P.R. China.
Medicine (Baltimore). 2021 Mar 26;100(12):e25120. doi: 10.1097/MD.0000000000025120.
This study was to assess the survival outcome of cutaneous melanoma (CM) patients with surgery vs non-surgery through inverse probability of treatment weighting (IPTW) using the propensity score. Patients diagnosed as CM were selected from the Surveillance, Epidemiology, and End Results Program (SEER) database. The survival outcome was estimated and compared by IPTW using the propensity score. Totally 2203 CM patients were identified, in which 1921 cases received surgical treatment (surgery group), while 282 cases didn't (non-surgery group). The median survival time of surgery and non-surgery groups was respectively 150 months and 15 months (unmatched cohort), 70 months and 40 months (matched cohort) and 130 months vs. 75 months (IPTW-weighted cohort). Compared with the non-surgery group, the surgery group had a lower risk of death in unmatched [hazard ratio (HR): 0.647, 95% confidence interval (CI): 0.509-0.821, P < .001] and matched (HR: 0.636, 95%CI: 0.459-0.882, P < .01) cohorts. In multivariate Cox model of IPTW-weighted cohort, the risk of death in the surgery group decreased notably than the non-surgery group (HR: 0.423, 95%CI: 0.383-0.468, P < .001). In conclusion, CM patients receiving surgical treatment are associated with a better survival outcome compared with those without surgical treatment through IPTW using the propensity score.
这项研究通过倾向评分逆概率处理加权(IPTW)评估了手术与非手术治疗皮肤黑色素瘤(CM)患者的生存结局。从监测、流行病学和最终结果(SEER)数据库中选择被诊断为 CM 的患者。通过使用倾向评分的 IPTW 来估计和比较生存结果。共确定了 2203 例 CM 患者,其中 1921 例接受了手术治疗(手术组),282 例未接受手术治疗(非手术组)。手术组和非手术组的中位生存时间分别为 150 个月和 15 个月(未匹配队列)、70 个月和 40 个月(匹配队列)以及 130 个月比 75 个月(IPTW 加权队列)。与非手术组相比,未匹配队列(风险比 [HR]:0.647,95%置信区间 [CI]:0.509-0.821,P<.001)和匹配队列(HR:0.636,95%CI:0.459-0.882,P<.01)中手术组的死亡风险较低。在 IPTW 加权队列的多变量 Cox 模型中,手术组的死亡风险明显低于非手术组(HR:0.423,95%CI:0.383-0.468,P<.001)。总之,通过倾向评分逆概率处理加权(IPTW),与未接受手术治疗的患者相比,接受手术治疗的 CM 患者的生存结局更好。