Acral Lentiginous Melanoma: Survival Analysis of 715 Cases
Acral Lentiginous Melanoma: Survival Analysis of 715 Cases
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DOI：
10.1177/1203475418800943
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发表时间：
2019-01-01
影响因子：
2.3
通讯作者：
Martinez-Said, Hector
中科院分区：
文献类型：
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作者：
Lino-Silva, Leonardo S.;Zepeda-Najar, Cesar;Martinez-Said, Hector
前言：肢端狼疮性黑色素瘤(ALM)是黑色素瘤的一种侵袭性变种，其发病率、患病率和预后因人群而异。我们分析了拉美裔人的临床病理特征和生存率，拉美裔人是ALM患病率较高的人群。材料和方法：从1144例黑色素瘤患者中，我们分析了来自国家转介癌症中心的715例施舍和429例非施舍，并比较了生存率。结果：ALM组中女性占62.8%，中位年龄58岁。平均Breslow厚度为3.56±7.16 mm。ALM患者在I期、II期和III期的疾病特异性生存率(DSS)估计分别为53.3%、52.7%和40.8%。在非ALM患者中，I期、II期和III期疾病的DSS发生率分别为66%、60.8%和48.4%。总体而言，ALM患者的1年、3年和5年DSS率分别为85.1%、59.4%和46.3%，而非ALM患者分别为81.3%、64.8%和55.7%(P=.168)。在多因素分析中，与DSS降低相关的因素有高Breslow厚度、复发、溃疡、男性和晚期。结论：ALM患者的1、3、5年DSS率与非ALM患者无统计学差异。除了已知的不良预后因素外，男性也与较差的存活率有关。
Introduction: Acral lentiginous melanoma (ALM) is an aggressive variant of melanoma; the incidence, prevalence, and prognosis differ among populations. We analyzed clinicopathological features and survival in Hispanics, a population with high ALM prevalence. Material and Methods: From 1144 patients with melanoma, we analyzed 715 ALMs and 429 non-ALMs from the National Referral Cancer Centre and compared survival. Results: Of the ALM group, 62.8% were female; the median age was 58 years. The mean Breslow thickness was 3.56 +/- 7.16 mm. ALM patients showed an estimated 5-year disease-specific survival (DSS) of 53.3%, 52.7%, and 40.8% for stage I, II, and III, respectively. For non-ALM patients, the DSS rates were 66%, 60.8%, and 48.4% for stage I, II, and III disease, respectively. Overall, the 1-, 3-, and 5-year DSS rates for patients with ALM were 85.1%, 59.4%, and 46.3%, respectively; for non-ALM patients, they were 81.3%, 64.8%, and 55.7%, respectively (P = .168). In the multivariate analysis, factors associated with decreased DSS were high Breslow thickness, recurrence, ulceration, male sex, and advanced stage. Conclusions: The 1-, 3-, and 5-year DSS rates of patients with ALM were not statistically different from those of non-ALM patients. In addition to known adverse prognostic factors, male sex was also associated with worse survival.