Is Sex an Independent Prognostic Factor in Cutaneous Head and Neck Melanoma?
Is Sex an Independent Prognostic Factor in Cutaneous Head and Neck Melanoma?
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DOI：
10.1002/lary.24439
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发表时间：
2014-06-01
期刊：
影响因子：
2.6
通讯作者：
Lentsch, Eric J.
中科院分区：
文献类型：
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作者：
Arce, Paolo M.;Camilon, P. Ryan;Lentsch, Eric J.
目的/假设：确定性别是否独立影响头颈部皮肤黑色素瘤患者的疾病特异性生存(DSS)。研究设计：对一个大型人群数据库进行回顾分析。方法：我们的研究包括2004年至2009年诊断的皮肤头颈部黑色素瘤患者的监测、流行病学和最终结果数据库。排除任何既往有恶性肿瘤病史或有多个原发灶的病例。我们获得了有关分期、种族、确诊年龄、放射治疗状态和手术治疗状态的数据。我们的分析包括Kaplan-Meier对DSS的性别分析[在最初在线发表后进行了更正]，并得到了所有研究变量的多变量Cox回归的支持。结果：2004至2009年间确诊的13,507名头颈部皮肤黑色素瘤患者。我们观察到女性患者比男性患者预后更好，5年DSS分别为90.40%(95%可信区间，89.03%~91.72%)和87.10%(95%CI，86.12%~88.08%)。多变量分析显示，女性的疾病特异性风险比在统计学上显著降低，与分期、治疗、年龄或种族无关。结论：我们的研究结论：女性是皮肤头颈部黑色素瘤的独立预后因素。与男性患者相比，女性患者的5年DSS表现更好。更好的预后可能是由于多种因素，包括不同的头发，阳光照射的水平，以及较高的男性年龄。
Objectives/Hypothesis: To determine if sex independently affects disease-specific survival (DSS) in patients with cutaneous head and neck melanoma.Study Design: Retrospective analysis of a large population database.Methods: Our study included patients in the Surveillance, Epidemiology, and End Results database with cutaneous head and neck melanoma diagnosed from 2004 to 2009. Any cases with a history of previous malignancy or with multiple primaries were excluded. We obtained data on stage, race, age at diagnosis, radiological treatment status, and surgical treatment status. Our analysis consisted of a Kaplan-Meier analysis of DSS by sex [correction made here after initial online publication] that was supported by a multivariate Cox regression of all significant variables studied.Results: There were 13,507 patients identified with cutaneous head and neck melanoma who were diagnosed between 2004 and 2009. We observed that female patients had a better prognosis than their male counterparts, with 5-year DSS of 90.40% (95% confidence interval [CI], 89.03%-91.72%) and 87.10% (95% CI, 86.12%-88.08%), respectively. Multivariable analysis demonstrated a statistically significant decrease in disease-specific hazard ratio due to female sex independent of stage, treatment, age, or race.Conclusions: Our study concludes that female sex is an independent prognostic factor for cutaneous head and neck melanoma. We demonstrated better 5-year DSS in female compared to male patients. Better prognosis could be due to multiple factors including differing hair, levels of sun exposure, and advanced male age.