危险系数
医学
比例危险模型
黑色素瘤
置信区间
内科学
肿瘤科
布雷斯洛厚度
多元分析
多元统计
癌症
癌症研究
乳腺癌
统计
数学
前哨淋巴结
作者
Ilaria Mattavelli,Roberto Patuzzo,Carlotta Galeone,Claudio Pelucchi,Gianfrancesco Gallino,Andrea Leva,Barbara Valeri,Mario Santinami,Andrea Maurichi
出处
期刊:Melanoma Research
[Ovid Technologies (Wolters Kluwer)]
日期:2023-05-05
卷期号:33 (4): 309-315
标识
DOI:10.1097/cmr.0000000000000898
摘要
Melanoma patients have a high risk of developing subsequent primary melanomas, a condition known as multiple primary melanoma (MPM). We aimed to compare risk factors of patients with MPM and single primary melanoma (SPM). Primary MPM and SPM consecutively treated at the National Cancer Institute in Milan, Italy, from 1978 to 2021 were retrospectively investigated. Demographic and clinicopathological characteristics were analyzed. Multivariate hazard ratios and mortality were estimated using Cox proportional hazards regression models. Overall, 9122 patients with SPM and 944 with MPM were included. A total of 1437 and 85 deaths occurred in SPM and MPM group, respectively. Of these, 1315 (14.4%) within SPM patients and 60 (6.4%) in MPM group were melanoma-specific deaths (MSDs). Males had a higher risk for MPM (hazard ratio = 1.29), while age was not associated with MPM (hazard ratio = 0.98). The risk of MPM decreased by about 50% for Breslow thickness >1 mm, and by about 45 and 75% in presence of mitoses and ulceration, respectively. The multivariate hazard ratio of death for MPM compared to SPM patients was 0.85 (95% confidence interval, CI: 0.67–1.06), while considering MSD the corresponding hazard ratio was 0.93 (95% CI: 0.71–1.22). Melanoma patients should receive regular follow-up with complete skin examination to detect early subsequent primary melanoma. Patients with more advanced primary have decreased risk of MPM, while males have higher risk. Our study reported no significant difference in mortality between SPM and MPM, but the issue is still open for discussion and further studies.
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