Comparing the characteristics and predicting the survival of patients with head and neck melanoma versus body melanoma: a population-based study.
Comparing the characteristics and predicting the survival of patients with head and neck melanoma versus body melanoma: a population-based study.
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DOI：
10.1186/s12885-021-08105-y
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发表时间：
2021-04-16
期刊：
影响因子：
3.8
通讯作者：
Lu Z
中科院分区：
文献类型：
--
作者：
Ding Y;Jiang R;Chen Y;Jing J;Yang X;Wu X;Zhang X;Xu J;Xu P;LiuHuang SC;Lu Z
以往的研究报道，头颈部皮肤黑色素瘤（HNM）不同于其他部位的皮肤黑色素瘤（BM）。预测HNM或BM患者生存期的个体化工具仍然不足。我们的目的是比较HNM和BM的特点，开发和验证用于预测HNM或BM患者生存的列线图。从监测、流行病学和最终结果（SEER）数据库中获得2004年至2015年HNM或BM患者的信息。HNM组和BM组随机分为训练和验证队列。我们使用Kaplan-Meier方法和多变量考克斯模型来确定独立的预后因素。通过rms和dynnom软件包绘制列线图，并通过一致性指数（C指数）、受试者工作特征（ROC）曲线的曲线下面积（AUC）和校准图进行测量。在70，605例患者中，21%患有HNM，79%患有BM。与BM组相比，HNM组包含更多的老年患者、男性和恶性雀斑样黑色素瘤，并且更频繁地具有更厚的肿瘤和转移。HNM组的5年癌症特异性生存率（CSS）和总生存率（OS）分别为88.1 ± 0.3%和74.4 ± 0.4%，BM组分别为92.5 ± 0.1%和85.8 ± 0.2%。确定了8个变量（年龄、性别、组织学、厚度、溃疡、分期、转移和手术），以构建HNM或BM患者的CSS和OS列线图。此外，网上还提供了四个动态列线图。每个诺模图的内部和外部验证显示出较高的C指数值（0.785-0.896）和AUC值（0.81-0.925），校准图显示出很好的一致性。HNM和BM的特征是异质的。我们构建并验证了4个列线图，用于预测HNM或BM患者的3年、5年和10年CSS和OS概率。这些列线图可作为生存预测和个人健康管理的实用临床工具。在线版本包含补充材料，可通过10.1186/s12885-021-08105-y获得。
Previous studies reported cutaneous melanoma in head and neck (HNM) differed from those in other regions (body melanoma, BM). Individualized tools to predict the survival of patients with HNM or BM remain insufficient. We aimed at comparing the characteristics of HNM and BM, developing and validating nomograms for predicting the survival of patients with HNM or BM. The information of patients with HNM or BM from 2004 to 2015 was obtained from the Surveillance, Epidemiology, and End Results (SEER) database. The HNM group and BM group were randomly divided into training and validation cohorts. We used the Kaplan-Meier method and multivariate Cox models to identify independent prognostic factors. Nomograms were developed via the rms and dynnom packages, and were measured by the concordance index (C-index), the area under the curve (AUC) of the receiver operating characteristic (ROC) curve and calibration plots. Of 70,605 patients acquired, 21% had HNM and 79% had BM. The HNM group contained more older patients, male sex and lentigo maligna melanoma, and more frequently had thicker tumors and metastases than the BM group. The 5-year cancer-specific survival (CSS) and overall survival (OS) rates were 88.1 ± 0.3% and 74.4 ± 0.4% in the HNM group and 92.5 ± 0.1% and 85.8 ± 0.2% in the BM group, respectively. Eight variables (age, sex, histology, thickness, ulceration, stage, metastases, and surgery) were identified to construct nomograms of CSS and OS for patients with HNM or BM. Additionally, four dynamic nomograms were available on web. The internal and external validation of each nomogram showed high C-index values (0.785–0.896) and AUC values (0.81–0.925), and the calibration plots showed great consistency. The characteristics of HNM and BM are heterogeneous. We constructed and validated four nomograms for predicting the 3-, 5- and 10-year CSS and OS probabilities of patients with HNM or BM. These nomograms can serve as practical clinical tools for survival prediction and individual health management. The online version contains supplementary material available at 10.1186/s12885-021-08105-y.
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