A MULTIVARIATE-ANALYSIS OF PROGNOSTIC FACTORS FOR MELANOMA PATIENTS WITH LESIONS-GREATER-THAN-OR-EQUAL-TO-3.65 MM IN THICKNESS - THE IMPORTANCE OF REVEALING ALTERNATIVE COX MODELS
A MULTIVARIATE-ANALYSIS OF PROGNOSTIC FACTORS FOR MELANOMA PATIENTS WITH LESIONS-GREATER-THAN-OR-EQUAL-TO-3.65 MM IN THICKNESS - THE IMPORTANCE OF REVEALING ALTERNATIVE COX MODELS
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DOI：
10.1097/00000658-198201001-00007
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发表时间：
1982-01-01
影响因子：
9
通讯作者：
GRIER, RW
中科院分区：
文献类型：
--
作者：
DAY, CL;LEW, RA;GRIER, RW
对79例临床I期黑色素瘤患者的14个预后因素进行了检测。厚度为3.65毫米。9例手足黑色素瘤患者全部死于黑色素瘤。对其余70例患者的Cox比例风险(多因素)分析显示，以下4个变量的组合最能预测骨转移或内脏转移：肿瘤底部几乎没有或最小的淋巴细胞反应，非浅表播散性黑色素瘤的组织类型，躯干上的位置，阳性结节或无初始结节清扫。溃疡和/或溃疡宽度不能单独或结合其他变量预测结果。躯干、手和脚的淋巴结阴性和原发肿瘤的患者并不比这些部位的淋巴结阳性的患者表现更好。
Fourteen prognostic factors were examined in 79 patients with clinical Stage I melanoma .gtoreq. 3.65 mm in thickness. All 9 patients with melanoma of the hands or feet died of melanoma. A Cox proportional hazards (multivariate) analysis of the remaining 70 patients showed that a combination of the following 4 variables best predicted bony or visceral metastases: a nearly absent or minimal lymphocyte response at the base of the tumor, histologic type other than superficial spreading melanoma, location on the trunk, and positive nodes or no initial node dissection. Ulceration and/or ulceration width were not useful in predicting outcome singly or in combination with other variables. Patients with negative lymph nodes and primary tumors of the trunk, hands and feet did not do better than patients with positive nodes at those sites. None of 16 patients with negative lymph nodes and extremity melanomas (excluding the hands and feet) or head and neck melanomas developed visceral or bony metastases (i.e., 5-yr disease-free survival rate 100%).