肢端黑色素瘤中 Breslow 厚度的预后影响：一项回顾性分析。
Prognostic impact of Breslow thickness in acral melanoma: A retrospective analysis.
作者信息
Wei Xiaoting, Chen Yu, Yao Hong, Wu Di, Li Hang, Zhang Rui, Chi Zhihong, Cui Chuanliang, Bai Xue, Mao Lili, Qi Zhonghui, Li Ke, Lan Shijie, Chen Lizhu, Guo Rui, Yao Xinyu, Lian Bin, Kong Yan, Dai Jie, Tang Bixia, Wang Xuan, Gershenwald Jeffrey E, Balch Charles M, Guo Jun, Si Lu
机构信息
Department of Melanoma and Sarcoma, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Peking University Cancer Hospital & Institute, Beijing, China.
Department of Medical Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fujian, China.
出版信息
J Am Acad Dermatol. 2022 Dec;87(6):1287-1294. doi: 10.1016/j.jaad.2022.08.052. Epub 2022 Sep 6.
BACKGROUND
Evidence for the prognostic importance of tumor thickness in acral melanoma (AM) patients is limited.
OBJECTIVE
The objective of the study was to determine the prognostic impact of Breslow thickness in AM.
METHODS
This multicenter study enrolled patients diagnosed with localized AM between January 1, 2000 and December 31, 2017. Melanoma-specific survival (MSS) in different tumor thickness strata (T1-T4: ≤1, >1-2, >2-4, >4 mm, respectively) was estimated by the Kaplan-Meier method. Comparisons were performed by the log-rank test and multivariable Cox regression.
RESULTS
A total of 853 patients with clinical N0 (cN0) AM were included in the analysis. The median follow-up time was 60.1 months. The median MSS in patients with T1-T4 disease was not reached, 111.0, 92.8, and 67.1 months, respectively. MSS differed significantly among cN0 patients with T1-T3 AM (log-rank P = .004, .012, <0.001 for T1 vs T2, T2 vs T3, and T1 vs T3, respectively); however, there was no significant difference between T3 and T4 AM (hazard ratio = 0.82, 95% CI, 0.62-1.09). Six-subgroup analyses confirmed that survival outcomes were similar between different subgroups with tumor thickness >2 mm.
LIMITATIONS
The limitations were retrospective design and some missing variables.
CONCLUSIONS
There was no association between tumor thickness and survival in AM patients with a Breslow thickness >2 mm.
背景
关于肿瘤厚度在肢端黑色素瘤（AM）患者预后中的重要性的证据有限。
目的
本研究的目的是确定 Breslow 厚度对 AM 的预后影响。
方法
这项多中心研究纳入了2000年1月1日至2017年12月31日期间被诊断为局限性 AM 的患者。通过 Kaplan-Meier 方法估计不同肿瘤厚度分层（T1-T4：分别为≤1、>1-2、>2-4、>4 mm）的黑色素瘤特异性生存率（MSS）。通过对数秩检验和多变量 Cox 回归进行比较。
结果
分析共纳入853例临床 N0（cN0）AM 患者。中位随访时间为60.1个月。T1-T4期疾病患者的中位MSS未达到，分别为111.0、92.8和67.1个月。cN0期T1-T3期AM患者的MSS有显著差异（T1与T2、T2与T3、T1与T3的对数秩P值分别为0.004、0.012、<0.001）；然而，T3期和T4期AM之间没有显著差异（风险比=0.82，95%CI，0.62-1.09）。六个亚组分析证实，肿瘤厚度>2 mm的不同亚组之间的生存结果相似。
局限性
局限性在于回顾性设计和一些变量缺失。
结论
Breslow厚度>2 mm的AM患者中，肿瘤厚度与生存之间无关联。
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