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Association between tumor characteristics and second primary cancers with cutaneous melanoma survival: A nationwide cohort study.
肿瘤特征和第二原发癌与皮肤黑色素瘤生存的相关性: 一项全国性队列研究。
- 影响因子:3.16
- DOI:10.1111/pcmr.12868
- 作者列表:"Zheng G","Chattopadhyay S","Sundquist K","Sundquist J","Försti A","Hemminki A","Hemminki K
- 发表时间:2020-02-03
Abstract
:The increased survival in malignant cutaneous melanoma (melanoma) is probably due to early diagnosis combined with improved treatment most recently. National health campaigns and screening programs for melanoma detection were started in Sweden several decades ago. We want to assess the influence of tumor characteristics, based on the TNM classification, and of second primary cancers on overall survival in melanoma. We used the Swedish Cancer Registry to assess all-cause survival in melanoma from 2003 to 2015. Hazard ratios (HRs) were estimated using multivariable Cox regression models. A total of 19,773 melanoma patients were diagnosed with TNM data. Survival showed a strong improving trend over time (p-trend <.001). T1a was the most common classification (48.0% of all), while higher T class was associated systematically with worse survival (p-trend <.001). For distant metastases, the HR was 3.17, accounting for 0.9% of the patients. Any types of second primary cancers, other than melanoma, were associated with an HR of 2.00, accounted for 6.7% of all cases. Even if melanoma survival in Sweden ranks among the best national rates, the large percentage of patients with advanced tumors (T3b, T4a, and T4b, 17%) and 21% of deaths with T1a call for improved preventive and follow-up strategies.
摘要
: 恶性皮肤黑色素瘤 (黑色素瘤) 的生存率增加可能是由于早期诊断结合最近改进的治疗。几十年前,瑞典开始了全国健康运动和黑色素瘤检测筛查项目。我们希望根据TNM分类评估肿瘤特征和第二原发癌对黑色素瘤总生存期的影响。我们使用瑞典癌症登记处评估了 2003 年至 2015 年黑色素瘤的全因生存率。使用多变量Cox回归模型估计风险比 (hr)。共有 19,773 例黑色素瘤患者被诊断为TNM数据。随着时间的推移,生存率表现出很强的改善趋势 (p趋势 <.001)。T1a是最常见的分类 (占所有分类的 48.0%),而较高的T分级与较差的生存率系统相关 (p趋势 <.001)。对于远处转移,HR为 3.17,占患者的 0.9%。除黑色素瘤外,任何类型的第二原发癌的HR均为 2.00,占所有病例的 6.7%。即使瑞典的黑色素瘤生存率在全国排名中名列前茅,晚期肿瘤患者的比例也很大 (T3b、T4a和T4b,17%) 21% 的T1a死亡病例呼吁改进预防和随访策略。
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