Department of Surgical Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Department of Surgical Oncology, Leiden University Medical Center, Leiden, The Netherlands.
J Surg Oncol. 2021 Sep;124(4):655-664. doi: 10.1002/jso.26555. Epub 2021 Jun 4.
Clinicopathologic characteristics have prognostic value in clinical stage IB-II patients with melanoma. Little is known about the prognostic value of obesity that has been associated with an increased risk for several cancer types and worsened prognosis after diagnosis. This study aims to examine effects of obesity on outcome in patients with clinical stage IB-II melanoma.
Prospectively recorded data of patients with clinical stage IB-II melanoma who underwent sentinel lymph node biopsy (SLNB) between 1995 and 2018 at the University Medical Center of Groningen were collected from medical files and retrospectively analyzed. Cox-regression analyses were used to determine associations between obesity (body mass index> 30), tumor (location, histology, Breslow-thickness, ulceration, mitotic rate, SLN-status) and patient-related variables (gender, age, and social-economic-status [SES]) and disease-free interval (DFI), melanoma-specific survival (MSS), and overall survival (OS).
Of the 715 patients, 355 (49.7%) were women, median age was 55 (range 18.6-89) years, 149 (20.8%) were obese. Obesity did not significantly affect DFI (adjusted hazard ratio [HR] = 1.40; 95% confidence interval [CI] = 0.98-2.00; p = 0.06), MSS (adjusted HR = 1.48;95%CI = 0.97-2.25; p = 0.07), and OS (adjusted HR = 1.25; 95% CI = 0.85-1.85; p = 0.25). Increased age, arm location, increased Breslow-thickness, ulceration, increased mitotic rate, and positive SLN-status were significantly associated with decreased DFI, MSS, and OS. Histology, sex, and SES were not associated.
Obesity was not associated with DFI, MSS, or OS in patients with clinical stage IB-II melanoma who underwent SLNB.
临床分期 IB-II 期黑色素瘤患者的临床病理特征具有预后价值。肥胖与多种癌症风险增加有关，且确诊后预后恶化，但人们对其预后价值知之甚少。本研究旨在探讨肥胖对临床分期 IB-II 期黑色素瘤患者结局的影响。
从病历中收集了 1995 年至 2018 年在格罗宁根大学医学中心接受前哨淋巴结活检（SLNB）的临床分期 IB-II 期黑色素瘤患者的前瞻性记录数据，并进行了回顾性分析。Cox 回归分析用于确定肥胖（体重指数>30）、肿瘤（位置、组织学、Breslow 厚度、溃疡、有丝分裂率、SLN 状态）和患者相关变量（性别、年龄和社会经济状况 [SES]）与无病间隔（DFI）、黑色素瘤特异性生存（MSS）和总生存（OS）之间的关联。
715 例患者中，355 例（49.7%）为女性，中位年龄为 55 岁（范围 18.6-89 岁），149 例（20.8%）肥胖。肥胖并未显著影响 DFI（调整后的危险比 [HR] = 1.40；95%置信区间 [CI] = 0.98-2.00；p = 0.06）、MSS（调整后的 HR = 1.48；95%CI = 0.97-2.25；p = 0.07）和 OS（调整后的 HR = 1.25；95%CI = 0.85-1.85；p = 0.25）。年龄较大、手臂位置、Breslow 厚度增加、溃疡、有丝分裂率增加和 SLN 阳性与 DFI、MSS 和 OS 降低显著相关。组织学、性别和 SES 无相关性。
在接受 SLNB 的临床分期 IB-II 期黑色素瘤患者中，肥胖与 DFI、MSS 或 OS 无关。
