皮肤黑色素瘤的解剖部位影响生存及临床结局：一项基于人群的分析。
Anatomic Region of Cutaneous Melanoma Impacts Survival and Clinical Outcomes: A Population-Based Analysis.
作者信息
Shannon Christian M, Mehta Neil K, Li Hong, Nguyen Shaun A, Koochakzadeh Sina, Elston Dirk M, Kaczmar John M, Day Terry A
机构信息
Department of Otolaryngology, Medical University of South Carolina, Charleston, SC 29425, USA.
Department of Otolaryngology, The Ohio State University College of Medicine, Columbus, OH 43210, USA.
出版信息
Cancers (Basel). 2023 Feb 15;15(4):1229. doi: 10.3390/cancers15041229.
PURPOSE
The objective was to determine the effects of the anatomic site of a cutaneous melanoma on the survival outcomes of diagnosed individuals.
METHODS
We conducted a cross-sectional study using data from the Surveillance, Epidemiology, and End Results Program (SEER) Database from 2004-2014 and included 178,892 cases of individuals diagnosed with cutaneous melanoma. Overall survival (OS) for each anatomic site as well as associated demographics, primary site, stage, and pathologic prognostic factors (Breslow's depth of invasion (DOI), level of mitoses, and ulceration), were analyzed.
RESULTS
Lower extremity melanoma (LEM) was the most likely to have locoregional nodal spread, yet head and neck melanoma (HNM) was the most likely to present at the most advanced stage of disease (IV). Independent of other factors, HNM was associated with the greatest risk of death (HR 1.90 [95% CI, 1.85-1.96]) compared to other sites, and males experienced worse overall survival (OS) (HR 1.74 [95% CI, 1.70-1.78]) compared to females. The last and greatest risk of death is associated with LEM and HNM, respectively.
CONCLUSION
Given these survival differences, consideration should be given to incorporating the primary site of melanoma into staging to ensure treatment is efficacious as possible.
目的
本研究旨在确定皮肤黑色素瘤的解剖部位对确诊患者生存结局的影响。
方法
我们采用2004年至2014年监测、流行病学和最终结果计划（SEER）数据库中的数据进行了一项横断面研究，纳入了178,892例确诊为皮肤黑色素瘤的患者。分析了每个解剖部位的总生存期（OS）以及相关的人口统计学特征、原发部位、分期和病理预后因素（Breslow浸润深度（DOI）、有丝分裂水平和溃疡情况）。
结果
下肢黑色素瘤（LEM）最易发生区域淋巴结转移，而头颈部黑色素瘤（HNM）最易在疾病最晚期（IV期）出现。与其他部位相比，独立于其他因素，HNM的死亡风险最高（风险比[HR]为1.90[95%置信区间（CI），1.85 - 1.96]），男性的总生存期（OS）比女性更差（HR为1.74[95%CI，1.70 - 1.78]）。最后，最大的死亡风险分别与LEM和HNM相关。
结论
鉴于这些生存差异，应考虑将黑色素瘤的原发部位纳入分期，以确保治疗尽可能有效。
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