American Joint Committee on Cancer (AJCC) Clinical Classification Predicts Conjunctival Melanoma Outcomes
American Joint Committee on Cancer (AJCC) Clinical Classification Predicts Conjunctival Melanoma Outcomes
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美国癌症联合委员会 (AJCC) 临床分类预测结膜黑色素瘤的结果
DOI：
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发表时间：
2012
影响因子：
2
通讯作者：
J. Shields
中科院分区：
文献类型：
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作者：
C. Shields;S. Kaliki;S. Al;S. Lally;J. Shields
目的：本研究的目的是根据美国癌症联合委员会分类评估结膜黑色素瘤的结局。研究设计构成了一个非随机干预性病例系列。研究方法：这是一项包括343名参与者的回顾性图表审查，主要结局指标为黑色素瘤局部复发、淋巴结转移、远处转移和死亡。结果如下：根据美国癌症联合委员会分类（第七版），结膜黑色素瘤被分类为T1（196 [57%]）、T2（110 [32%]）、T3（37 [11%]）和T4（0）。平均肿瘤基底直径随着肿瘤分期而增加，T1为8.5 mm，T2为12.7 mm（p = 0.0003），T3为16 mm（p < 0.0001）。黑色素瘤源于原发性获得性黑变病（T1 = 71%; T2 = 84%; T3 = 81%）、既存痣（T1 = 8%; T2 = 5%; T3 = 3%）或新发（T1 = 21%; T2 = 12%; T3 = 16%）。5年结局（Kaplan-Meier）显示T1组44%、T2组78%的黑色素瘤局部复发/新发肿瘤（p < 0.0001），76% T3（P=0.0044）; T1和T2区域淋巴结转移率分别为17%和52%（p < 0.0001），49% T3（p = 0.0092）; T1组11%，T2组35%的黑素瘤相关远处转移（p < 0.0001）和42%T3（p = 0.0018）;以及5%T1、20%T2（p = 0.0655）和23%T3（p = 0.0526）的黑素瘤相关死亡。基于美国癌症联合委员会分类，预测黑素瘤复发的因素包括T2分期（p < 0.0001）和T3分期（p = 0.0061）。校正肿瘤来源后，预测区域淋巴结转移、黑素瘤相关远处转移和黑素瘤相关死亡的因素包括：0001; p <0.0001; p <0.0001）、T2期（p <0.0001; p < 0.0001; p = 0.007）和T3期（p = 0.005; p = 0.0014; p = 0.0342）。结论：美国癌症联合委员会分期可预测结膜黑色素瘤的预后。与T1相比，T2和T3期黑色素瘤的局部复发率、区域淋巴结转移率、远处转移率和死亡率均显著增高。
Purpose: The aim of this study was to evaluate conjunctival melanoma outcomes based on American Joint Committee on Cancer classification. The study design constituted a nonrandomized interventional case series. Methods: This was a retrospective chart review comprising 343 participants, and the main outcome measures were melanoma local recurrence, lymph node metastasis, distant metastasis, and death. Results: On the basis of the American Joint Committee on Cancer classification (seventh edition), conjunctival melanoma was classified as T1 (196 [57%]), T2 (110 [32%]), T3 (37 [11%]), and T4 (0). The mean tumor basal diameter increased with tumor staging with 8.5 mm for T1, 12.7 mm for T2 (p = 0.0003), and 16 mm for T3 (p < 0.0001). The melanoma arose from primary acquired melanosis (T1 = 71%; T2 = 84%; T3 = 81%), preexisting nevus (T1 = 8%; T2 = 5%; T3 = 3%), or de novo (T1 = 21%; T2 = 12%; T3 = 16%). Outcomes at 5 years (Kaplan–Meier) revealed melanoma local recurrence/new tumor in 44% T1, 78% T2 (p < 0.0001), and 76% T3 (P=0.0044); regional lymph node metastasis in 17% T1, 52% T2 (p < 0.0001), and 49% T3 (p = 0.0092); melanoma-related distant metastasis in 11% T1, 35% T2 (p < 0.0001), and 42% T3 (p = 0.0018); and melanoma-related death in 5% T1, 20% T2 (p = 0.0655), and 23% T3 (p = 0.0526). Based on American Joint Committee on Cancer classification, factors predictive of melanoma recurrence included T2 stage (p < 0.0001), and T3 stage (p = 0.0061). After adjusting for tumor origin, factors predictive of regional lymph node metastasis, melanoma-related distant metastasis, and melanoma-related death included melanoma arising de novo (p < 0.0001; p < 0.0001; p < 0.0001), T2 stage (p < 0.0001; p < 0.0001; p = 0.007), and T3 stage (p = 0.005; p = 0.0014; p = 0.0342). Conclusion: The American Joint Committee on Cancer staging predicts prognosis of conjunctival melanoma. Melanoma classified as T2 and T3 (compared with T1) showed significantly higher rates of local recurrence, regional lymph node metastasis, distant metastasis, and death.