Balzi D, Carli P, Giannotti B, Buiatti E
Registro Tumori Toscano, U.O. di Epidemiologia, Presidio per la Prevenzione Oncologica, Azienda Ospedaliera Careggi, Firenze, Italy.
Eur J Cancer. 1998 Apr;34(5):699-704. doi: 10.1016/s0959-8049(97)10119-8.
Survival and prognostic factors of invasive cutaneous melanoma patients diagnosed in the province of Florence, Italy, were studied using a regression analysis of relative survival rates. The case series consisted of 428 patients reported by the Tuscany Cancer Registry between 1985 and 1989. The effect of gender, age, anatomical site, histological type and microstaging parameters upon relative survival were evaluated using an extension of the Cox proportional hazard model. Five-year relative survival was 70%; 8-year relative survival, referring to a subset of patients, was 67%. In univariate analysis, the following variables were significantly associated with better prognosis: female gender, age younger than 60 years, superficial spreading melanoma (SSM) compared with nodular melanoma (NM), location on the limbs, a thinner lesion according to Breslow, a shallower Clark level. Females had a clear-cut prognostic advantage over males in each category of the variables considered above. After simultaneous adjustment for all other variables, three factors continued to show an independent prognostic effect: age, gender and microstaging parameters (Breslow thickness and Clark level, separately fitted in the model). In the multivariate analysis, the prognostic advantage of females over males was specifically seen for lesions located on the trunk and for both SSM and NM histotype.
利用相对生存率的回归分析，对意大利佛罗伦萨省诊断出的侵袭性皮肤黑色素瘤患者的生存及预后因素进行了研究。病例系列包括托斯卡纳癌症登记处在1985年至1989年期间报告的428例患者。使用Cox比例风险模型的扩展评估了性别、年龄、解剖部位、组织学类型和微分期参数对相对生存的影响。五年相对生存率为70%；针对一部分患者的八年相对生存率为67%。在单变量分析中，以下变量与较好的预后显著相关：女性、年龄小于60岁、与结节性黑色素瘤（NM）相比的浅表扩散性黑色素瘤（SSM）、四肢部位、根据Breslow标准较薄的病灶、较浅的Clark分级。在上述各类变量中，女性的预后明显优于男性。在对所有其他变量进行同时调整后，三个因素继续显示出独立的预后效应：年龄、性别和微分期参数（Breslow厚度和Clark分级，分别纳入模型）。在多变量分析中，女性相对于男性的预后优势在躯干部位的病灶以及SSM和NM组织学类型中尤为明显。
