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恶性黑色素瘤患者发生远处转移的预后因素。

Prognostic factors for in-transit metastasis in patients with malignant melanoma.

作者信息

Gâta Vlad Alexandru, Roman Andrei, Muntean Maximilian, Morariu Dragoş Ştefan, Vlad Cătălin Ioan, Bonci Eduard Alexandru, Irimie Alexandru, Achimaş-Cadariu Patriciu

机构信息

Department of Oncology, Faculty of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.

Department of Surgical Oncology, "Prof. Dr. Ion Chiricuta" Institute of Oncology, Cluj-Napoca, Romania.

出版信息

Med Pharm Rep. 2022 Jan;95(1):40-46. doi: 10.15386/mpr-2173. Epub 2022 Jan 31.

Abstract

BACKGROUND AND AIMS

Malignant melanoma represents an aggressive and unpredictable malignancy, with high locoregional recurrence rates, regardless of tumor stage and therapeutic management. This study aims to identify the main histopathological prognostic factors involved in the development of in-transit metastasis in patients with malignant melanoma.

METHODS

The study includes only patients that were diagnosed with malignant melanoma and with histologically confirmed in-transit metastasis who were treated in a comprehensive cancer center between 2010-2021. Histopathological parameters were investigated, univariate and multivariate analysis was performed.

RESULTS

A total of 26 patients were included in the analysis. On univariate and multivariate analysis, only primary cutaneous melanomas located on the thorax correlated with the risk of developing in-transit metastasis, whereas clinicopathological factors such as an increased Breslow thickness and Clark level, the presence of ulceration, positive lymph nodes, a non-brisk TIL density, a high mitotic rate, a nodular subtype, and age >50 years may represent risk factors, even though we could not find any correlations.

CONCLUSIONS

Primary cutaneous melanomas that arise on the thorax present a high risk for the occurrence of locoregional disease, whereas other clinicopathological characteristics could not be used to predict local recurrence. However, prospective and more extensive cohort studies are needed in order to validate these important prognostic factors.

摘要

背景与目的

恶性黑色素瘤是一种侵袭性且不可预测的恶性肿瘤,无论肿瘤分期和治疗方式如何,局部区域复发率都很高。本研究旨在确定恶性黑色素瘤患者发生移行转移的主要组织病理学预后因素。

方法

该研究仅纳入2010年至2021年间在一家综合癌症中心接受治疗、被诊断为恶性黑色素瘤且经组织学证实有移行转移的患者。对组织病理学参数进行研究,并进行单因素和多因素分析。

结果

共有26例患者纳入分析。单因素和多因素分析显示,仅胸部原发性皮肤黑色素瘤与发生移行转移的风险相关,而诸如Breslow厚度增加、Clark分级、溃疡的存在、阳性淋巴结、低活性肿瘤浸润淋巴细胞密度、高有丝分裂率、结节亚型以及年龄>50岁等临床病理因素可能是风险因素,尽管我们未发现任何相关性。

结论

胸部原发性皮肤黑色素瘤发生局部区域疾病的风险很高,而其他临床病理特征无法用于预测局部复发。然而,需要进行前瞻性且更广泛的队列研究以验证这些重要的预后因素。

相似文献

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[Risk factors for in-transit metastasis in patients with cutaneous melanoma].[皮肤黑色素瘤患者发生途中转移的危险因素]
Actas Dermosifiliogr. 2012 Apr;103(3):207-13. doi: 10.1016/j.ad.2011.06.002. Epub 2011 Sep 6.

本文引用的文献

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Advanced stage melanoma therapies: Detailing the present and exploring the future.晚期黑色素瘤治疗方法:详述现状,探索未来。
Crit Rev Oncol Hematol. 2019 Jan;133:99-111. doi: 10.1016/j.critrevonc.2018.11.002. Epub 2018 Nov 15.
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Contemporary Approaches to In-Transit Melanoma.当代转运期黑色素瘤处理方法。
J Oncol Pract. 2018 May;14(5):292-300. doi: 10.1200/JOP.18.00063.
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Genetic alterations in main candidate genes during melanoma progression.黑色素瘤进展过程中主要候选基因的基因改变。
Oncotarget. 2018 Jan 3;9(9):8531-8541. doi: 10.18632/oncotarget.23989. eCollection 2018 Feb 2.

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