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脑和脊柱转移性黑色素瘤的人口统计学特征。在单一三级中心进行的回顾性分析。

Demographics aspects of brain and spine metastatic melanoma. Retrospective analysis in a single third-level center.

作者信息

Vega-Moreno Daniel Alejandro, Kuramitsu Shunichiro, Kaoru Eguchi, Yasukazu Kajita, García-González Ulises, Ibarra-de la Torre Abraham, Hernández-Hernández Liliana, Vicuña-González Rosa María, González-Jiménez Martha Elena

机构信息

Neurosurgery and Patology Department, Hospital Central Sur de Alta Especialidad, "PEMEX", Mexico City, Mexico.

Neurosurgery Department, Nagoya Medical Center, National Hospital Organization, Aichi, Nagoya, Japan.

出版信息

World Neurosurg X. 2024 Feb 25;22:100306. doi: 10.1016/j.wnsx.2024.100306. eCollection 2024 Apr.

Abstract

BACKGROUND

Melanoma metastases to the CNS rank third in frequency, just after lung and breast metastases. There is controversy regarding the factors predisposing to developing CNS metastases in patients with cutaneous melanoma and their survival with conventional treatments.

METHODS

We carried out a retrospective analysis in a third-level hospital in Mexico to determine epidemiological aspects of melanoma metastases to the central nervous system, factors related to its appearance, clinical presentation, and survival in three treatment groups: surgery, radiotherapy, and conservative management.

RESULTS

We found that the nodular variant has the most significant association with CNS metastases. In addition, the superficial spreading variant has the highest risk of presenting a more substantial number of lesions, up to seven for each case and predominantly in the infratentorial space. On the other hand, we found more remarkable survival in patients treated only with surgery than those treated with radiotherapy or conservatively.

CONCLUSIONS

This study lays the foundations for future prospective survival analysis of the different current treatment modalities for metastatic melanoma in the brain and spine. It also highlights the clinical risk factors for metastatic brain and spine tumors of melanoma.

摘要

背景

黑色素瘤转移至中枢神经系统(CNS)的频率位列第三,仅次于肺和乳腺转移。对于皮肤黑色素瘤患者发生CNS转移的易感因素及其接受传统治疗后的生存情况存在争议。

方法

我们在墨西哥的一家三级医院进行了一项回顾性分析,以确定黑色素瘤转移至中枢神经系统的流行病学特征、与转移发生相关的因素、临床表现以及三个治疗组(手术、放疗和保守治疗)的生存情况。

结果

我们发现结节型变体与CNS转移的关联最为显著。此外,浅表扩散型变体出现更多病灶的风险最高,每例可达7个,且主要位于幕下间隙。另一方面,我们发现仅接受手术治疗的患者比接受放疗或保守治疗的患者生存情况更好。

结论

本研究为未来对脑和脊柱转移性黑色素瘤当前不同治疗方式的前瞻性生存分析奠定了基础。它还突出了黑色素瘤脑和脊柱转移瘤的临床风险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19e2/10918258/e21846401dcd/gr1.jpg

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