Five-year survival in patients with nodular and superficial spreading melanomas in the US population
Five-year survival in patients with nodular and superficial spreading melanomas in the US population
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DOI：
10.1016/j.jaad.2020.11.047
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发表时间：
2021-03-11
影响因子：
13.8
通讯作者：
Venna, Suraj
中科院分区：
文献类型：
--
作者：
Allais, Blair S.;Beatson, Meghan;Venna, Suraj
背景：虽然浅表扩散性黑色素瘤 (SSM) 被诊断为较薄的病变，但结节性黑色素瘤 (NM) 与其他组织学亚型相比，生长速度更快，生物学上更具侵袭性。目的：确定相同 Breslow 深度和 TNM 分期的 NM 和 SSM 患者 5 年相对生存率的差异。方法：基于人群的横断面分析使用数据比较 NM 和 SSM 患者的 5 年相对生存率来自国家癌症研究所的监测、流行病学和最终结果 (SEER)*Stat 软件（版本 8.2.1-8.3.5）。卡方检验比较比例，Kaplan-Meier法与Z评分比较5年相对生存率。结果：对于2004年至2009年间接受诊断的患者，NM的5年相对生存率低于SSM（53.7% vs 87.3%；Z评分，-41.35；P < .001）。同样，对于 2010 年至 2015 年间接受诊断的患者，NM 的 5 年相对生存率低于 SSM（61.5% vs 89.7%；Z 评分，-2.7078；P < .01）。亚组分析显示，T1b 期 NM 的生存率较差，排除淋巴结或远处转移的患者后，生存率差异仍然显着。结论：与 SSM 相比，NM 的五年相对生存率较差，尤其是在 T1b、T2a 和 T2b 黑色素瘤中。提出治疗建议时应考虑黑色素瘤亚型。
Background: Although superficial spreading melanomas (SSM) are diagnosed as thinner lesions, nodular melanomas (NM) have a more rapid growth rate and are biologically more aggressive compared with other histologic subtypes.Objective: To determine the difference in 5-year relative survival in patients with NM and SSM at the same Breslow depth and TNM stage.Methods: A population-based cross-sectional analysis compared the 5-year relative survival of patients with NM and SSM using data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER)*Stat software (version 8.2.1-8.3.5). Chi-square tests compared the proportions, and Kaplan-Meier method with Z-score compared 5-year relative survival.Results: For patients receiving a diagnosis between 2004 and 2009, 5-year relative survival was lower in NM compared with SSM (53.7% vs 87.3%; Z score, -41.35; P < .001). Similarly, for patients receiving a diagnosis between 2010 and 2015, 5-year relative survival was lower in NM compared with SSM (61.5% vs 89.7%; Z score, -2.7078; P < .01). Subgroup analyses showed inferior survival in NM in T1b, and survival differences remained significant after excluding patients with nodal or distant metastases.Conclusions: Five-year relative survival is worse in NM compared with SSM especially in T1b, T2a, and T2b melanomas. Melanoma subtype should be taken into consideration when making treatment recommendations.