Riaz Nazia, Huibers Anne, Leong Stanley P, Kashani-Sabet Mohammed, White Richard L, Vetto John T, Schneebaum Schlomo, O'Donoghue Cristina, Howard Harrison, Avisar Eli, Namm Jukes P, Kosiorek Heidi, Pockaj Barbara, Faries Mark, Karakousis Giorgos, Zager Jonathan S, Olofsson Bagge Roger
Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Ann Surg Oncol. 2025 May;32(5):3189-3197. doi: 10.1245/s10434-025-16945-2. Epub 2025 Feb 1.
Although most melanomas develop de novo, about 30% are nevus-associated melanomas, where the prognostic value is unclear. Our study aimed to determine whether nevus-associated melanoma is associated with sentinel lymph node (SLN) status and prognosis in patients with melanoma.
The Sentinel Lymph Node Working Group database, which includes comprehensive clinicopathological and outcome data, was utilized to investigate the association of nevus-associated melanoma with SLN status as well as relapse-free (RFS), melanoma-specific (MSS), and overall survival (OS) using multivariable logistic regression and Cox regression modeling.
A total of 3447 adult patients with a median follow-up of 2.6 years (interquartile range 0.9-6.9) were evaluable. Compared with de novo melanomas, nevus-associated melanomas showed a significant correlation with younger age as well as favorable histological features. The presence of a nevus-associated melanoma was not identified as an independent factor for SLN status (odds ratio 1.06, 95% confidence interval [CI] 0.80-1.41; p = 0.68). Compared with de novo melanomas, nevus-associated melanomas provided independent prognostic information for a favorable RFS (hazard ratio [HR] 0.67, 95% CI 0.53-0.84; p < 0.001), MSS (HR 0.54, 95% CI 0.34-0.85; p = 0.008), and OS (HR 0.42, 95% CI 0.30-0.57; p < 0.001).
Melanomas associated with pre-existing nevi appear to be an independent favorable prognostic factor for recurrence and survival and may potentially be used as a clinical parameter for identifying patients with lower risk of recurrence.
虽然大多数黑色素瘤是新发的，但约30%是痣相关黑色素瘤，其预后价值尚不清楚。我们的研究旨在确定痣相关黑色素瘤是否与黑色素瘤患者的前哨淋巴结（SLN）状态及预后相关。
利用哨兵淋巴结工作组数据库，该数据库包含全面的临床病理和结局数据，采用多变量逻辑回归和Cox回归模型研究痣相关黑色素瘤与SLN状态以及无复发生存期（RFS）、黑色素瘤特异性生存期（MSS）和总生存期（OS）之间的关联。
共有3447例成年患者可纳入评估，中位随访时间为2.6年（四分位间距0.9 - 6.9年）。与新发黑色素瘤相比，痣相关黑色素瘤与较年轻的年龄以及良好的组织学特征显著相关。痣相关黑色素瘤的存在未被确定为SLN状态的独立因素（优势比1.06，95%置信区间[CI] 0.80 - 1.41；p = 0.68）。与新发黑色素瘤相比，痣相关黑色素瘤为良好的RFS（风险比[HR] 0.67，95% CI 0.53 - 0.84；p < 0.001）、MSS（HR 0.54，95% CI 0.34 - 0.85；p = 0.008）和OS（HR 0.42，95% CI 0.30 - 0.57；p < 0.001）提供了独立的预后信息。
与既往存在的痣相关的黑色素瘤似乎是复发和生存的独立有利预后因素，可能潜在地用作识别复发风险较低患者的临床参数。
