Vitiligo is an independent favourable prognostic factor in stage III and IV metastatic melanoma patients: results from a single-institution hospital-based observational cohort study
Vitiligo is an independent favourable prognostic factor in stage III and IV metastatic melanoma patients: results from a single-institution hospital-based observational cohort study
复制标题
DOI：
10.1093/annonc/mdp325
复制
发表时间：
2010-02-01
影响因子：
50.5
通讯作者：
Bernengo, M. G.
中科院分区：
文献类型：
--
作者：
Quaglino, P.;Marenco, F.;Bernengo, M. G.
背景：黑色素瘤患者白癜风的临床特征和预后相关性仍然存在争议。这项前瞻性观察研究的目的是探讨黑色素瘤相关白癜风的临床特征，分析与其他自身免疫表现的相关性，并确定白癜风病变的发展是否与黑色素瘤的临床病程有预后相关性。多因素分析的无远处转移生存（DMFS）和总生存（OS）进行了确定白癜风作为一个时间依赖的协变量的独立预后作用。结果：白癜风被证明在83 2954黑色素瘤患者（2.8%）。白癜风患者自身免疫性疾病的比例（83例中的7例）明显高于非白癜风患者（2871例中的80例）（P = 0.004）。多变量分析选择的时间依赖性协变量白癜风作为有利的独立预后变量相关联的较长的DMFS在III期和更高的OS在III期和IV期。结论：黑色素瘤相关的白癜风应被视为一个独特的临床实体，从白癜风寻常，并确定一个亚组的特点是高患病率的免疫介导的疾病和良好的预后。
Background: The clinical features and the prognostic relevance of vitiligo lesions in melanoma patients are still controversial. This prospective observational study was designed to characterise the clinical features of melanoma-associated vitiligo, to analyse the association with other autoimmune manifestations and to ascertain whether the development of vitiligo lesions carries a prognostic relevance on the clinical course of melanoma.Materials and methods: A total of 2954 consecutive patients have been included; multivariate analyses of distant metastasis-free survival (DMFS) and overall survival (OS) were carried out to ascertain the independent prognostic role of vitiligo as a time-dependent covariate.Results: Vitiligo was demonstrated in 83 of 2954 melanoma patients (2.8%). A significantly higher percentage of autoimmune diseases was demonstrated in vitiligo patients (7 of 83) with respect to patients without vitiligo (80 of 2871) (P = 0.004). Multivariate analyses selected the time-dependent covariate vitiligo as the favourable independent prognostic variable associated to a longer DMFS in stage III and a higher OS in both stage III and stage IV.Conclusion: Melanoma-associated vitiligo should be considered as a distinct clinical entity, separate from vitiligo vulgaris, and identifies a subgroup of patients characterised by a high prevalence of immune-mediated diseases and by a favourable prognosis.