Gender Differences in Melanoma Survival: Female Patients Have a Decreased Risk of Metastasis
Gender Differences in Melanoma Survival: Female Patients Have a Decreased Risk of Metastasis
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DOI：
10.1038/jid.2010.354
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发表时间：
2011-03-01
影响因子：
6.5
通讯作者：
Engel, Jutta
中科院分区：
文献类型：
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作者：
Joosse, Arjen;de Vries, Esther;Engel, Jutta
女性黑色素瘤患者通常表现出比男性患者显著更长的生存期。这项基于人群的队列研究旨在研究皮肤黑色素瘤所有阶段的生存率和疾病进展的性别差异。从慕尼黑癌症登记处（德国）提取的11,774例黑色素瘤病例，在1978年至2007年9月期间诊断，符合进入研究的条件。根据肿瘤和患者特征调整风险比（HR）和95%置信区间（CI），评估生存期、局部和全身进展以及进展后生存期的终点。在黑色素瘤特异性生存率方面，观察到女性具有显著优势（校正HR 0.62; 95% CI 0.56-0.70）。女性的进展风险较低（HR 0.68; 95% CI 0.62-0.75），包括淋巴结转移（HR 0.58; 95% CI 0.51-0.65）和内脏转移（HR 0.56; 95% CI 0.49-0.65）的风险较低。在首次进展（HR 0.81; 95% CI 0.71-0.92）和淋巴结转移（HR 0.80; 95% CI 0.66-0.96）后，它们仍保持显著的生存优势，但在内脏转移后，这变得边缘显著（HR 0.88; 95% CI 0.76-1.03）。与男性相比，女性的局限性黑色素瘤转移倾向较低，即使在首次疾病进展后，生存率也更高。这些结果表明肿瘤-宿主相互作用在性别上存在差异。
Female melanoma patients generally exhibit significantly longer survival than male patients. This population-based cohort study aimed to investigate gender differences in survival and disease progression across all stages of cutaneous melanoma. A total of 11,774 melanoma cases extracted from the Munich Cancer Registry (Germany), diagnosed between 1978 and September 2007, were eligible to enter the study. Hazard ratios (HRs) and 95% confidence intervals (CIs), adjusted for tumor and patient characteristics, were estimated for the end points of survival, regional and systemic progression, and survival after progression. A significant female advantage was observed for melanoma-specific survival (adjusted HR 0.62; 95% CI 0.56-0.70). Women were at a lower risk of progression (HR 0.68; 95% CI 0.62-0.75), including a lower risk of lymph node metastasis (HR 0.58; 95% CI 0.51-0.65) and visceral metastases (HR 0.56; 95% CI 0.49-0.65). They retained a significant survival advantage after first progression (HR 0.81; 95% CI 0.71-0.92) and lymph node metastasis (HR 0.80; 95% CI 0.66-0.96), but this became borderline significant (HR 0.88; 95% CI 0.76-1.03) after visceral metastasis. Localized melanomas in women had a lower propensity to metastasize, resulting in a better survival when compared with men, even after first disease progression. These results suggest differences in tumor-host interaction across gender.