摘要
目的探讨皮肤恶性黑色素瘤的临床病理特征及预后相关因素。方法回顾性分析南京鼓楼医院2010年1月至2016年6月收治的74例皮肤黑色素瘤患者的临床病理资料。所有入组患者均接受手术治疗,术后辅助治疗分为联合免疫治疗和未联合免疫治疗,免疫治疗方法包括细胞因子治疗和过继性免疫细胞回输疗法,未联合免疫治疗者包括术后未治疗的以及术后仅行辅助放疗或辅助化疗的患者。根据随访资料分析预后情况,并采用Cox比例风险回归模型分析影响预后的因素。结果全组患者的中位生存期(OS)和无病生存期(DFS)分别为32.0个月(95%CI:20.2~43.8个月)和23.0个月(95%CI:16.4~29.6个月)。Ⅲ期患者术后联合免疫治疗较未联合免疫治疗中位OS延长(38.0个月vs.10.0个月,P=0.002)。多因素分析显示,年龄、分期、淋巴结转移、原发灶溃疡和肿瘤Breslow厚度是影响皮肤黑色素瘤OS的独立因子,分期、淋巴结转移、原发灶溃疡和肿瘤Breslow厚度是影响DFS的独立因子。结论年龄、分期、淋巴结转移、肿瘤Breslow厚度和原发灶溃疡均与皮肤恶性黑色素瘤患者的预后密切相关。Ⅲ期患者术后联合免疫治疗可延长OS。
Objective To explore the clinical characteristics and prognostic factors of patients with cutaneous melanoma. Methods A total of 74 cutaneous melanoma patients treated in Nanjing Drum Tower Hospital from January 2010 to June 2016 were enrolled. All patients received operation in this study. According to adjuvant therapy after operation, patients were divided into two groups ： patients with or without immunotherapy. Immunotherapy included adoptive T-cell transfer and eytokine therapy. Patients without immunotherapy consisted of patients without therapy and patients with only radiotherapy or chemotherapy after operation. We retrospec- tively collected clinicopathological data in order to calculate survival and identify the main prognostic factors using Cox proportional hazards regression model. Results Median overall survival （OS） and disease-free survival （DFS） of all patients were 32.0 months （95% C I： 20. 2-43.8） and 23.0 months （95% CI： 16.4-29. 6） , respectively. For patients of stage lU, the median OS was extended in those receiving immunotherapy followed by surgery than those without combined immunotherapy（ 38.0 months vs. 10. 0 months, P= 0. 002）. In multivariate analysis, age, clinical stage, lymph node metastasis, ulceration and Breslow thickness were significant prognostic factors for OS. In addition, clinical stage, lymph node metastasis, ulceration and BresIow thickness were significant prognostic factors for DFS. Conclusion The age, clinical stage, lymph node metastasis, Breslow thickness and ulceration were associated with prognosis of patients with cutaneous melanoma. Postoperative combined immunotherapy can prolong the OS of patients with stage Ⅲ.
出处
《临床肿瘤学杂志》
CAS
2017年第3期249-254,共6页
Chinese Clinical Oncology
基金
南京市医学科技发展项目医学重点科技发展项目(ZKX15012)
