Hazard rates for recurrent and secondary cutaneous melanoma: An analysis of 33,384 patients in the German Central Malignant Melanoma Registry

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY

卷:66

Article

Leiter, Ulrike¹  Buettner, Petra G.²  Eigentler, Thomas K.¹  Broecker, Eva B.³  Voit, Christiane⁴  Gollnick, Harald⁵  Marsch, Wolfgang⁶  Wollina, Uwe⁷  Meier, Friedegund¹  Garbe, Claus^1,2 

[1] Univ Tubingen, Ctr Dermatooncol, Dept Dermatol, D-72076 Tubingen, Germany

[2] James Cook Univ, Sch Publ Hlth Trop Med & Rehabil Sci, Townsville, Qld 4811, Australia

[3] Univ Wurzburg, Dept Dermatol, D-97070 Wurzburg, Germany

[4] Univ Berlin, Charite, Dept Dermatol, Berlin, Germany

[5] Univ Magdeburg, Dept Dermatol, D-39106 Magdeburg, Germany

[6] Univ Halle, Dept Dermatol, Halle, Germany

[7] Acad Teaching Hosp Dresden Friedrichstadt, Dept Dermatol, Dresden, Germany

关键词: cutaneous melanoma;    hazard rates;    recurrences;    survival analysis;   

DOI  :  10.1016/j.jaad.2010.09.772

来源: Elsevier

【 摘 要 】

Background: Knowledge about the risk for recurrence and secondary cutaneous melanoma (CM) is an important basis for patient counseling and planning of follow-up examinations. Objectives: This study aimed to analyze stage- and time-dependent hazard rates (FIR) and discusses current surveillance recommendations. Methods: Follow-up data of 33,384 patients with incident CM in stages I to III (American Joint Committee on Cancer 2002) were recorded by the German Central Malignant Melanoma Registry in 1976 through 2007. Survival was based on Kaplan-Meier estimates and HRs were calculated. Results: Recurrences were recorded in 4999 patients (stage I, 7.1%; stage II, 32.8%; and stage III, 51.0%). Ten-year recurrence-free survival was 78.9% (95% confidence interval 73.1-90.5); in stage I, 89.0%; stage II, 56.9%; and stage III, 36.0%. Whereas FIR for recurrent CM showed a constantly low level less than or equal to 1:125 per year for stage IA, clearly higher Hits of greater than or equal to 1:40 were recorded in stage IB for the first 3 years and generally in stages II to Ill. Of all patients 2.3% developed secondary melanomas, with a consistently low HR of less than 1:220 per year. Limitations: As German recommendations discontinued regular follow-up examinations after 10 years, no information can be given beyond this time point. Follow-up data of longer than 5 years were available in 41.4% of patients. Conclusion: For patients at stage IA with thin melanoma and low HR for recurrent CM the need for surveillance remains questionable. For patients with higher HR greater than 1:40 per year, intensified surveillance strategies should be taken into account. (J Am Acad Dermatol 2012;66:37-45.)

【 授权许可】

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