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Melanoma in older patients: declining gap in survival between younger and older patients with melanoma.

老年患者中的黑色素瘤: 年轻和老年黑色素瘤患者之间的生存差距下降。

  • 影响因子:2.78
  • DOI:10.1080/0284186X.2019.1643914
  • 作者列表:"Schuurman MS","Hollestein LM","Bastiaannet E","Posthuma EFM","van Akkooi AJC","Kukutsch NA","Aarts MJB","Wakkee M","Lemmens VEPP","Louwman MWJ
  • 发表时间:2020-01-01
Abstract

:Background: Older people have the highest incidence of melanoma and the population in most Western countries is ageing. We evaluated how the gap in incidence and survival between younger and older patients has developed during the past decades.Material and methods: All patients diagnosed with cutaneous melanoma between 1989 and 2015 (n = 84,827) were identified from the Netherlands Cancer Registry. Elderly were defined as aged ≥70 years. Differences in patient and tumor characteristics were described, age-specific incidence rates were calculated, and relative survival (RS) and multivariable analyses estimating the Relative Excess Rate of dying (RER) were conductedResults: In older men, the melanoma age-standardized incidence increased from 18 to 103/100,000 person-years (py) between 1989 and 2015 and in older women from 23 to 70/100,000 py. In younger men and women, it increased from 8 to 21 and from 13 to 28/100,000 py, respectively. Median Breslow thickness declined from 1.8 to 1.1 mm and from 1.6 to 1.1 mm in older men and women (2003 versus 2015), and from 1.1 to 0.9 mm and 0.9 to 0.8 mm in younger men and women. In older men, 5-year RS increased from 67% (95% CI: 63%-72%) in 1989-1997 to 85% (95% CI: 83%-87%) in 2007-2015 and in older women from 81% (95% CI: 78%-85%) to 89% (95% CI: 87%-91%). In younger men and women, RS increased from 82% (95% CI: 81%-83%) to 90% (95% CI: 90%-91%) and from 92% (95% CI: 92%-93%) to 96% (95% CI: 95%-96%). After case-mix correction , older men and women no longer showed an improved survival over time (RER 2010-2015 versus 2003-2009: 0.97; 95% CI: 0.81-1.16 and 0.95; 95% CI: 0.79-1.16). Whereas in younger men and women survival remained improved (RER 0.75; 95% CI: 0.67-0.83 and 0.77; 95%CI: 0.67-0.89).Conclusion: The gap in melanoma incidence between younger and older people is increasing due to a strong increase in incidence in older adults. Disparities in survival are declining, related to a narrowing gap in Breslow thickness.

摘要

背景: 老年人黑色素瘤的发病率最高,在大多数西方国家人口正在老龄化。我们评估了过去几十年中年轻患者和老年患者之间的发病率和生存率差距是如何发展的。材料和方法: 1989 年至 2015 年间诊断为皮肤黑色素瘤的所有患者 (n = 84,827) 均来自荷兰癌症登记处。老年人定义为年龄 ≥ 70 岁。描述了患者和肿瘤特征的差异,计算了年龄特异性发病率,并进行了相对生存率 (RS) 和估计相对超额死亡率 (RER) 的多变量分析。结果: 在老年男性中,黑色素瘤的年龄标准化发病率从 18 增加到 103/100,000 人-年 (py)1989 年至 2015 年之间,老年女性 23 ~ 70/100 py。在年轻男性和女性中,它分别从 8 增加到 21,从 13 增加到 28/100 py。老年男性和女性的Breslow厚度中位数从 1.8 下降到 1.1,从 1.6 下降到 1.1 (2003 对 2015),从 1.1 到 0.9 毫米和 0.9 到 0.8 毫米的年轻男女。在老年男性中,5 年RS从 67%-95% 年的 63% (72% CI: 1989-1997) 增加到 85% (95% CI: 83%-87%) 在 2007-2015 和老年女性中,从 81% (95% CI: 78%-85%) 到 89% (95% CI: 87%-91%)。在年轻男性和女性中,RS从 82% (95% CI: 81%-83%) 增加到 90% (95% CI: 90%-91%) 和从 92% (95% CI: 92%-93%) to 96% (95% CI: 95%-96%)。病例组合校正后,老年男性和女性随着时间的推移不再表现出生存率的改善 (RER 2010-2015 vs 2003-2009: 0.97; 95% CI: 0.81-1.16 和 0.95; 95% CI: 0.79-1.16)。而年轻男性和女性的生存率仍然提高 (RER 0.75; 95% CI: 0.67-0.83 和 0.77; 95% CI: 0.67-0.89)。结论: 由于老年人的发病率急剧增加,年轻人和老年人之间黑色素瘤发病率的差距正在增加。生存率差异正在下降,与Breslow厚度差距缩小有关。

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皮肤肿瘤方向

皮肤肿瘤是发生在皮肤的细胞增生性疾病,是一种常见病。发生于皮内或皮下组织的新生物,种类很多,临床上分良性肿瘤和恶性肿瘤。恶性肿瘤可以不断增殖,引起转移,威胁生命,称为皮肤癌。

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