泌尿系统原发性恶性黑色素瘤的生存预后分析:基于SEER数据库的一项研究

Survival analysis of patients with primary malignant melanoma of urinary system:a SEER database study

目的 探究影响泌尿系统原发性恶性黑色素瘤(PMMU)患者预后的危险因素及治疗方案。方法 筛选并获取SEER数据库中55例PMMU患者的临床资料,采用Kaplan-Meier分析法计算患者的总生存(OS)率及肿瘤特异性生存(CSS)率,对随访数据进行单因素及多因素Cox回归分析,分析因素包括性别、年龄、诊断年份、种族、肿瘤原发部位、肿瘤分期、肿瘤原发灶手术方式、区域淋巴结清扫、放化疗情况、围手术期系统治疗、原发肿瘤大小。结果 PMMU患者的CSS期平均为84.1个月,1年、3年、5年的CSS率分别为76.1%、42.8%、32.4%;OS期平均为57.8个月,1年、3年、5年的OS率分别为72.8%、36.5%、25.1%。Cox回归分析显示肿瘤原发部位、肿瘤分期为影响患者CSS、OS的独立预后危险因素,而手术、放化疗及围手术期系统治疗对患者预后无明显改善。结论 本研究得出肿瘤的原发部位和分期为PMMU的独立预后危险因素,可用于预测患者的预后,而现阶段的治疗手段对PMMU患者的预后无明显改善,未来还需不断探索更多新型的治疗方法。

Objective To explore the risk factors affecting prognosis and treatment of patients with primary malignant melanoma of urinary system(PMMU).Methods We identified 55 patients diagnosed with PMMU from 1975 to 2019 in the Surveillance,Epidemiology,and End Results(SEER)database.Kaplan-Meier analysis was used to calculate the cancer-specific survival(CSS)and overall survival(OS),and Cox regression analysis was used to analyze the relationship among the influencing factors.The analysis factors included sex,age at diagnosis,year of diagnosis,race,primary site of tumor,tumor stage,surgery of primary tumors,regional lymph node dissection,chemoradiotherapy,perioperative systemic treatment and tumor size.Results The average cancer-specific survival time of PMMU patients was 84.1 months,and the 1-year,3-year and 5-year CSS were 76.1%,42.8%and 32.4%,respectively.The average overall survival time was 57.8 months,and the 1-year,3-year and 5-year OS were 72.8%,36.5%and 25.1%respectively.Regression analysis showed that the primary site and stage of tumor were independent prognostic risk factors for CSS and OS,but surgery,chemoradiotherapy and perioperative systemic treatment had no significant effect on prognosis of PMMU.Conclusions The study concluded that the primary site and stage of tumor are independent prognostic risk factors of PMMU,which can be used to predict the prognosis of patients.However,the current treatment methods have no significant improvement on the prognosis of patients with PMMU.In the future,more new treatment methods need to be constantly explored.