手术治疗肛门黑色素瘤辅助治疗的影响。

Impact of adjuvant therapies following surgery for anal melanoma.

机构信息

Department of Surgery, University of Tennessee Health Science Center, 910 Madison Ave., Suite 300, Memphis, TN, 38103, USA.

出版信息

Am J Surg. 2022 Jun;223(6):1132-1143. doi: 10.1016/j.amjsurg.2021.10.041. Epub 2021 Nov 11.

DOI:10.1016/j.amjsurg.2021.10.041

PMID:34801225

Abstract

BACKGROUND

Anal melanoma is rare. Surgery is standard of care for non-metastatic disease. There are limited data supporting adjuvant therapy. We sought to examine the impact of adjuvant radiation, chemotherapy and immunotherapy on survival.

METHODS

The National Cancer Database was queried. Factors associated with overall survival were examined by Kaplan-Meier and Cox proportional hazards analyses. Patients were grouped by treatment regimen.

RESULTS

450 patients had complete treatment data: surgery alone (63.8%), surgery + radiation (14.9%), surgery + chemotherapy (7.6%), surgery + immunotherapy (9.6%) and non-surgical treatment (4.2%). Median survival was 27.2 months. Node-positive patients had worse survival than node-negative (22.4 vs. 36.8 months; p = 0.0002). Non-surgical treatment yielded worse survival than any surgery-inclusive regimen (10.4 vs. 27.8 months; p = 0.0002). No adjuvant modality conferred a survival advantage. By multivariate analysis, increasing age (HR/1 year = 1.02, p = 0.012) and node positivity (HR = 2.10, p = 0.0002) negatively impacted survival.

CONCLUSION

Adjuvant therapy for non-metastatic anal melanoma does not appear to influence survival.

摘要

背景

肛门黑色素瘤较为罕见。手术是非转移性疾病的标准治疗方法。支持辅助治疗的数据有限。我们试图研究辅助放疗、化疗和免疫疗法对生存率的影响。

方法

查询国家癌症数据库。通过 Kaplan-Meier 和 Cox 比例风险分析检查与总生存率相关的因素。根据治疗方案对患者进行分组。

结果

450 名患者有完整的治疗数据：单纯手术（63.8%）、手术+放疗（14.9%）、手术+化疗（7.6%）、手术+免疫疗法（9.6%）和非手术治疗（4.2%）。中位生存期为 27.2 个月。淋巴结阳性患者的生存情况比淋巴结阴性患者差（22.4 与 36.8 个月；p=0.0002）。与任何包含手术的治疗方案相比，非手术治疗的生存情况更差（10.4 与 27.8 个月；p=0.0002）。没有任何辅助治疗方法能提高生存率。多因素分析显示，年龄增加（每增加 1 年 HR=1.02，p=0.012）和淋巴结阳性（HR=2.10，p=0.0002）会对生存情况产生负面影响。