Prognosis for patients with thin cutaneous melanoma - Long-term survival data from the New South Wales Central Cancer Registry and the Sydney Melanoma Unit
Prognosis for patients with thin cutaneous melanoma - Long-term survival data from the New South Wales Central Cancer Registry and the Sydney Melanoma Unit
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DOI：
10.1002/cncr.11624
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发表时间：
2003-09-15
期刊：
影响因子：
6.2
通讯作者：
Thompson, JF
中科院分区：
文献类型：
--
作者：
McKinnon, JG;Yu, XO;Thompson, JF
背景对于薄的（小于或等于1 mm）原发性皮肤黑色素瘤患者的长期生存率估计差异很大。两种不同的方法被用来研究来自澳大利亚新南威尔士州（NSW）和悉尼黑色素瘤单位（SMU）的黑色素瘤患者的生存率。新南威尔士州中央癌症登记处（NSWCCR）提供了1983年至1998年（含）期间诊断为皮肤黑色素瘤厚度小于或等于1 mm的所有患者的数据。诊断时有转移的患者不包括在内，留下18，088例患者进行分析。分析SMU数据库，以提取1979年至1998年符合相同标准的所有薄黑素瘤患者的数据。所有在其他地方接受过原发性肿瘤明确治疗的患者都被排除在外，留下2746名患者进行分析。计算10年Kaplan-Meier生存率，并使用对数秩分析确定显著差异。预后因素采用考克斯比例风险分析。NSWCCR分析显示10年生存率为96.4%。SMU患者的10年生存率为92.7%。在SMU死亡的患者中，中位复发时间为49.8个月，中位死亡时间为65.9个月。SMU病灶小于或等于0.75 mm的患者的10年生存率为96.9%，而病灶为0.76-1.0 mm的患者的10年生存率为84.3%。对于溃疡性黑色素瘤厚度小于或等于1 mm的患者，10年生存率为83%，而非溃疡性黑色素瘤患者为92.3%。目前的研究结果证实了薄黑色素瘤患者的良好生存率。可以识别出可能需要考虑积极调查和治疗的高风险患者亚群。癌症（C）2003年美国癌症协会。
BACKGROUND. Estimates of long-term survival for patients with thin (less than or equal to 1 mm) primary cutaneous melanomas vary widely. Two separate methods were used to study the survival of patients with melanoma from New South Wales (NSW), Australia, and from the Sydney Melanoma Unit (SMU).METHODS. The NSW Central Cancer Registry (NSWCCR) provided data on all patients who were diagnosed with cutaneous melanomas that measured less than or equal to 1 mm thick between 1983 and 1998, inclusive. Patients with metastases at the time of diagnosis were not included, leaving 18,088 patients for analysis. The SMU data base was analyzed to extract data for all patients with thin melanomas who met the same criteria from 1979 to 1998, inclusive. All patients who had their primary tumors treated definitively elsewhere were excluded, leaving 2746 patients for analysis. Ten-year Kaplan-Meier survival rates were calculated, and significant differences were determined using log-rank analysis. Prognostic factors were evaluated with Cox proportional hazards analysis.RESULTS. The NSWCCR analysis revealed a 10-year survival rate of 96.4%. The 10-year survival rate for patients at SMU was 92.7%. Among the patients at SMU who died, the median time to recurrence was 49.8 months, and the median time to death was 65.9 months. The 10-year survival for patients at SMU who had lesions that measured less than or equal to 0.75 mm was 96.9% compared with 84.3% for patients who had lesions that measured 0.76-1.0 mm. For patients who had ulcerated melanomas measuring less than or equal to 1 mm thick, the 10-year survival rate was 83%, compared with 92.3% for patients who had nonulcerated melanomas.CONCLUSIONS. The results of the current study confirmed the excellent survival rate for patients with thin melanomas. Higher-risk subsets of patients who may warrant consideration for aggressive investigation and treatment are identifiable. Cancer (C) 2003 American Cancer Society.