Martínez Guisella, Bobadilla Francisco, Kinzel Francisca, Fernández Javier, Sazunic Ivo, Delgado María Magdalena, Segovia Laura, Zamudio Andrea, Vega Nadia
Department of Dermatology, Faculty of Medicine, University of Chile, Santiago, Chile.
Dermatology Service, Hospital Barros Luco Trudeau, Santiago, Chile.
Dermatol Pract Concept. 2023 Oct 1;13(4):e2023273. doi: 10.5826/dpc.1304a273.
A low socioeconomic status (SES) is associated with lower survival rates in cutaneous malignant melanoma (CMM). In South America, there are few studies that analyze CMM data according to SES.
To determine the differences in microstaging and overall survival in CMM between public and private health care centers.
Retrospective cohort study. Histopathological reports with a diagnosis of CMM from two public hospitals (PuH) and one private health care center (PrH) in Santiago from 2008 to 2018 were included. Patients' death certificates were obtained to estimate overall survival.
1014 MMC were found. The mean age was 58.6 ± 16.8 years and 59.9% corresponded to female patients. Of these, 33.9% received treatment at PuH and 66.1% at PrH. Patients from PuH had an increased risk of having an invasive CMM and a >1 mm thickness melanoma compared to PrH (odds ratio 2.77 and 6.06, respectively). Patients with invasive CMM from the PuH were 6.29-fold more likely to die than a patient from the PrH.
We observed a great disparity in tumor thickness between the socioeconomic status, reflecting a later detection and lower survival rate in PuH. Our results highlight a gap on which National Public Health should focus.
社会经济地位低下与皮肤恶性黑色素瘤(CMM)的较低生存率相关。在南美洲,很少有研究根据社会经济地位分析CMM数据。
确定公立和私立医疗中心在CMM的微分期和总生存率方面的差异。
回顾性队列研究。纳入了2008年至2018年在圣地亚哥两家公立医院(PuH)和一家私立医疗中心(PrH)诊断为CMM的组织病理学报告。获取患者死亡证明以估计总生存率。
共发现1014例CMM。平均年龄为58.6±16.8岁,59.9%为女性患者。其中,33.9%在PuH接受治疗,66.1%在PrH接受治疗。与PrH相比,PuH的患者发生浸润性CMM和厚度>1mm黑色素瘤的风险增加(优势比分别为2.77和6.06)。PuH的浸润性CMM患者死亡的可能性是PrH患者的6.29倍。
我们观察到社会经济地位之间肿瘤厚度存在巨大差异,这反映了PuH的检测较晚且生存率较低。我们的结果凸显了国家公共卫生应关注的差距。