62例Ⅰ、Ⅱ期皮肤恶性黑素瘤回顾性分析

Retrospective analysis of 62 patients with stage Ⅰ and Ⅱ cutaneous malignant melanoma

目的探讨影响Ⅰ、Ⅱ期皮肤恶性黑素瘤预后的独立因素。方法回顾性分析62例Ⅰ、Ⅱ期皮肤恶性黑素瘤的临床病理资料,应用Kaplan-Meier法计算生存率,通过Cox比例风险模型确立影响患者预后的独立因素。结果 62例Ⅰ、Ⅱ期皮肤恶性黑素瘤患者术后3年和5年生存率分别为90.3%和82.3%。单因素分析显示性别、年龄、临床分期、病理分型、手术方式、淋巴结消除是影响Ⅰ、Ⅱ期皮肤恶性黑素瘤生存率的因素。多因素分析显示年龄、性别、临床分期、手术方式是影响Ⅰ、Ⅱ期皮肤恶性黑素瘤预后的独立因素。结论性别、年龄、临床分期、手术方式是影响Ⅰ、Ⅱ期皮肤恶性黑素瘤预后的独立因素,Mohs外科手术可改善Ⅰ、Ⅱ期皮肤恶性黑素瘤患者的预后。

Objective To investigate the independent factors influencing prognosis of stage Ⅰ and Ⅱ cutaneous malignant melanoma.Methods Clinicopathological data of 62 patients with stage Ⅰ and Ⅱ cutaneous malignant melanoma were retrospectively analyzed.The survival rates were calculated by Kaplan-Meier method.The independent factors influencing prognosis were established by Cox proportional hazards model.Results The 3-and 5-year survival rates of the 62 patients with stage Ⅰ and Ⅱ cutaneous malignant melanoma were 90.3% and 82.3%.Univariable analysis showed that gender,age,clinical stage,pathologic type,surgical modality,lymph node dissection were the factors influencing survival rate of stage Ⅰ and Ⅱ cutaneous malignant melanoma.Multivariate analysis showed that gender,age,clinical stage and surgical modality were the independent factors influencing prognosis of stage Ⅰ and Ⅱ cutaneous malignant melanoma.Conclusion Gender,age,clinical stage and surgical modality are the independent factors influencing prognosis of stage Ⅰ and Ⅱ cutaneous malignant melanoma.Mohs surgery can improve the prognosis of stage Ⅰ and Ⅱ cutaneous malignant melanoma.