Tian Y, Li M W, Liu Q K, Kang H
Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Zhonghua Zhong Liu Za Zhi. 2022 Oct 23;44(10):1146-1154. doi: 10.3760/cma.j.cn112152-20200818-00751.
To analyze the clinical features and prognosis of patients with cutaneous melanoma. The clinical data and follow-up data of 125 patients with cutaneous malignant melanoma (CMM) treated in the Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology between February 2008 and August 2019 were collected. Kaplan-Meier method and Log rank test were used for survival analysis, and Cox proportional risk regression model was used for impact factor analysis. Among the 125 patients, 12 were stage Ⅰ, 62 were stage Ⅱ, 30 were stage Ⅲ, and 21 were stage Ⅳ; 76 were acral and 49 were non-acral. The median survival time was 44 months, and the 1-, 2-, and 5-year survival rates were 85.4%, 63.2% and 38.7%, respectively. Kaplan-Meier univariate survival analysis showed that Karnofsky performance status score, tumor stage, primary site, vascular infiltration, Ki-67, BRAF, lactate dehydrogenase (LDH), and surgical treatment were related to the prognosis of patients (<0.05). The median overall survival (OS) time of patients receiving interferon treatment was 53 months, which was better than 40 months of patients not receiving interferon treatment, but the difference was not statistically significant (=0.448). Among stage Ⅲ patients, the median OS time of patients receiving interferon therapy was 40 months, which was better than 17 months of patients not receiving interferon therapy (=0.012). Among stage Ⅱ patients, the 1-, 2-, and 5-year survival rates of acral patients were 97.1%, 84.7%, and 65.8%, and the 1-, 2-, and 5-year survival rates of non-acral patients were 93.3%, 70.0% and 17.0%. The prognosis of patients with stage Ⅱ acral type was better than that of non-acral type (=0.043). The median survival time of stage Ⅲ patients with acral type was 32 months, better than 17 months of non-acral type, but the difference was not statistical significance (=0.164). The median survival time of acral type and non-acral type was 8 months and 11 months respectively (=0.458). Cox multivariate analysis showed that tumor stage and preoperative LDH level were independent prognostic risk factors for cutaneous melanoma. Interferon treatment can improve the prognosis of patients with stage Ⅲ, and stage Ⅱ acral type patients have better prognosis than that of non-acral type patients. Tumor stage and preoperative LDH level were independent prognostic risk factors for cutaneous melanoma.
分析皮肤黑色素瘤患者的临床特征及预后。收集了2008年2月至2019年8月在华中科技大学同济医学院附属同济医院接受治疗的125例皮肤恶性黑色素瘤(CMM)患者的临床资料及随访数据。采用Kaplan-Meier法和Log rank检验进行生存分析,采用Cox比例风险回归模型进行影响因素分析。125例患者中,Ⅰ期12例,Ⅱ期62例,Ⅲ期30例,Ⅳ期21例;肢端型76例,非肢端型49例。中位生存时间为44个月,1年、2年和5年生存率分别为85.4%、63.2%和38.7%。Kaplan-Meier单因素生存分析显示,卡氏功能状态评分、肿瘤分期、原发部位、血管浸润、Ki-67、BRAF、乳酸脱氢酶(LDH)及手术治疗与患者预后相关(<0.05)。接受干扰素治疗患者的中位总生存(OS)时间为53个月,优于未接受干扰素治疗患者的40个月,但差异无统计学意义(=0.448)。在Ⅲ期患者中,接受干扰素治疗患者的中位OS时间为40个月,优于未接受干扰素治疗患者的17个月(=0.012)。在Ⅱ期患者中,肢端型患者的1年、2年和5年生存率分别为97.1%、84.7%和65.8%,非肢端型患者的1年、2年和5年生存率分别为93.3%、70.0%和17.0%。Ⅱ期肢端型患者的预后优于非肢端型患者(=0.043)。Ⅲ期肢端型患者的中位生存时间为32个月,优于非肢端型患者的17个月,但差异无统计学意义(=0.164)。肢端型和非肢端型的中位生存时间分别为8个月和11个月(=0.458)。Cox多因素分析显示,肿瘤分期和术前LDH水平是皮肤黑色素瘤独立的预后危险因素。干扰素治疗可改善Ⅲ期患者的预后,Ⅱ期肢端型患者的预后优于非肢端型患者。肿瘤分期和术前LDH水平是皮肤黑色素瘤独立的预后危险因素。