首页> 外文期刊>Journal of the European Academy of Dermatology and Venereology: JEADV >Late recurrence of melanoma after 10?years – Is the course of the disease different from early recurrences?
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Late recurrence of melanoma after 10?years – Is the course of the disease different from early recurrences?

机译:十六岁后黑素瘤的后期复发 - 是疾病的过程不同于早期复发吗?

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Abstract Background It is known that melanoma can metastasize and recur many years after the first diagnosis. Although predictive and prognostic factors for melanoma are well defined, there is still insufficient information about the factors affecting the recurrence period and the effect of the recurrence time to survival. Objectives This study investigates the course of melanoma to show prognostic factors comparing early and late recurrence patients. The main objective is to uncover the effect of the recurrence time on the progression of the disease. Methods In this retrospective study, late recurrence ( LR ) was defined as melanoma recurrence 10?years after the first diagnosis and early recurrence ( ER ) was defined as recurrence within 10?years. Gender, age, localization of primary tumour, time to first metastasis, survival rates, histological subtype, stage, tumour thickness, invasion level, ulceration and regression of the primary melanoma were documented. Survival curves were evaluated using the Kaplan–Meier and compared with the log‐rank test. Multivariate Cox proportional hazard models were used to identify significant independent prognostic factors for melanoma‐specific survival ( MSS ). Results A total of 1537 melanoma patients were analysed. Early metastasis was developed in 1438 patients (93.6%), and 99 patients (6.4%) developed late metastasis. Late recurrence patients were younger ( P ??0.001) and had fewer ulcerated ( P ?=?0.005), fewer head/neck localized ( P ?=?0.009) and thinner ( P ??0.001) melanomas than ER patients. The MSS time (mean?±? SD ) was nearly identical for LR (31?±?4.4?months 95% CI [22.3–39.7]) and ER (32?±?1.9?months [28.3–35.7]). Multivariate regression analysis revealed male gender (hazard ratio [ HR ?=?1.4, P ??0.001), truncal tumour localization ( HR ?=?1.7, P ??0.001), tumour thickness ( HR ?=?1.4, P ??0.045) and ulceration ( HR ?=?1.3, P ??0.008) as significant independent prognostic factors for MSS . Conclusion Although ER and LR patients are found to have different clinicopathologic features, the time of the first recurrence after diagnosis do not seem to have an effect on the survival.
机译:摘要背景众所周知,黑色素瘤可以在第一次诊断后多年转移和重复。虽然黑色素瘤的预测性和预测因素定义很好,但仍有关于影响复发期的因素的信息仍然不足以及复发时间生存的影响。目的本研究调查了黑色素瘤的过程,以显示早期和晚期复发患者的预后因素。主要目的是揭示复发时间对疾病进展的影响。方法在这种回顾性研究中,晚期复发(LR)定义为黑色素瘤复发10?第一次诊断和早期复发(ER)定义为10岁以下的复发。性别,年龄,原发性肿瘤的定位,第一次转移的时间,存活率,组织学亚型,阶段,肿瘤厚度,侵袭水平,溃疡,初级黑素瘤的溃疡和回归。使用Kaplan-Meier评估生存曲线,并与日志秩检验进行比较。多元COX比例危险模型用于鉴定对特异性黑素瘤的存活率(MSS)的显着独立的预后因素。结果共分析了1537名黑色素瘤患者。早期的转移是在1438名患者(93.6%)和99名患者(6.4%)发生后期转移中。晚期复发患者较年轻(p≤≤0.001)并且溃疡较少(p?= 0.005),头/颈部局部(p?= 0.009)和稀释剂(p≤≤0.001)melanomas比呃耐心。 MSS时间(平均值?±3)几乎相同(31?±4.4?月95%CI [22.3-39.7])和ER(32?±1.9?月份[28.3-35.7])。多元回归分析显示男性性别(危害比[HR?=Δ1.4,p≤0.001),突发肿瘤定位(Hr?=Δ1.7,p≤1.0.01),肿瘤厚度(Hr?=?1.4 ,p?0.045)和溃疡(Hr?=Δ1.3,p≤x≤0.008)作为MSS的显着独立的预后因素。结论虽然发现ER和LR患者有不同的临床病理特征,但诊断后第一次复发的时间似乎对存活率没有影响。

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