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Titolo:
Prognostic factors analysis of 17,600 melanoma patients: Validation of theAmerican Joint Committee on Cancer melanoma staging system
Autore:
Balch, CM; Soong, SJ; Gershenwald, JE; Thompson, JF; Reintgen, DS; Cascinelli, N; Urist, M; McMasters, KM; Ross, MI; Kirkwood, JM; Atkins, MB; Thompson, JA; Coit, DG; Byrd, D; Desmond, R; Zhang, YT; Liu, PY; Lyman, GH; Morabito, A;
Indirizzi:
Amer Soc Clin Oncol, Alexandria, VA 22314 USA Amer Soc Clin Oncol Alexandria VA USA 22314 col, Alexandria, VA 22314 USA Johns Hopkins Med Inst, Baltimore, MD USA Johns Hopkins Med Inst Baltimore MD USA kins Med Inst, Baltimore, MD USA Univ Alabama, Birmingham, AL USA Univ Alabama Birmingham AL USAUniv Alabama, Birmingham, AL USA Univ Texas, MD Anderson Canc Ctr, Houston, TX 77030 USA Univ Texas Houston TX USA 77030 Anderson Canc Ctr, Houston, TX 77030 USA Univ Sydney, Sydney Melanoma Unit, Sydney, NSW 2006, Australia Univ Sydney Sydney NSW Australia 2006 a Unit, Sydney, NSW 2006, Australia Univ S Florida, H Lee Moffitt Canc Ctr, Tampa, FL 33682 USA Univ S Florida Tampa FL USA 33682 e Moffitt Canc Ctr, Tampa, FL 33682 USA WHO, Melanoma Program, Ist Nazl Tumori, Milan, Italy WHO Milan ItalyWHO, Melanoma Program, Ist Nazl Tumori, Milan, Italy Univ Louisville, Med Ctr, Louisville, KY 40292 USA Univ Louisville Louisville KY USA 40292 Med Ctr, Louisville, KY 40292 USA Univ Pittsburgh, Med Ctr, Pittsburgh, PA USA Univ Pittsburgh Pittsburgh PA USA ittsburgh, Med Ctr, Pittsburgh, PA USA Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA Beth Israel Deaconess Med Ctr Boston MA USA 02215 r, Boston, MA 02215 USA Univ Washington, Med Ctr, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 gton, Med Ctr, Seattle, WA 98195 USA Fred Hutchinson Canc Res Ctr, Seattle, WA 98104 USA Fred Hutchinson Canc Res Ctr Seattle WA USA 98104 , Seattle, WA 98104 USA Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA Mem Sloan Kettering Canc Ctr New York NY USA 10021 New York, NY 10021 USA
Titolo Testata:
JOURNAL OF CLINICAL ONCOLOGY
fascicolo: 16, volume: 19, anno: 2001,
pagine: 3622 - 3634
SICI:
0732-183X(20010815)19:16<3622:PFAO1M>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
CUTANEOUS MALIGNANT-MELANOMA; LYMPH-NODE METASTASES; MULTIFACTORIAL ANALYSIS; MULTIVARIATE-ANALYSIS; I MELANOMA; LONG-TERM; BRESLOW THICKNESS; TUMOR THICKNESS; LACTATE-DEHYDROGENASE; HISTOLOGICAL FEATURES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
80
Recensione:
Indirizzi per estratti:
Indirizzo: Balch, CM Amer Soc Clin Oncol, 1900 Duke St,Ste 200, Alexandria, VA 22314 USA Amer Soc Clin Oncol 1900 Duke St,Ste 200 Alexandria VA USA 22314
Citazione:
C.M. Balch et al., "Prognostic factors analysis of 17,600 melanoma patients: Validation of theAmerican Joint Committee on Cancer melanoma staging system", J CL ONCOL, 19(16), 2001, pp. 3622-3634

Abstract

Purpose: The American Joint Committee on Cancer (AJCC) recently proposed major revisions of the tumor-node-metastases (TNM) categories and stage groupings for cutaneous melanoma. Thirteen cancer centers and cancer cooperative groups contributed staging and survival data from a total of 30,450 melanoma patients from their databases in order to validate this staging proposal. Patients and Methods: There were 17,600 melanoma patients with complete clinical, pathologic, and follow-up information. Factors predicting melanoma-specific survival rates were analyzed using the Cox proportional hazards regression model. Follow-up survival data for 5 years or longer were available for 73% of the patients. Results: This analysis demonstrated that (1) in the T category, tumor thickness and ulceration were the most powerful predictors of survival, and thelevel of invasion had a significant impact only within the subgroup of thin (less than or equal to 1 mm) melanomas; (2) in the N category, the following three independent factors were identified: the number of metastatic nodes, whether nodal metastases were clinically occult or clinically apparent,and the presence or absence of primary tumor ulceration; and (3) in the M category, nonvisceral metastases was associated with a better survival compared with visceral metastases. A marked diversity in the natural history ofpathologic stage III melanoma was demonstrated by five-fold differences in5-year survival rates for defined subgroups. This analysis also demonstrated that large and complex data sets could be used effectively to examine prognosis and survival outcome in melanoma patients. Conclusion: The results of this evidence-based methodology were incorporated into the AJCC melanoma staging as described in the companion publication. J Clin Oncol 19:3622-3634. (C) 2001 by American Society of Clinical Oncology.

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Documento generato il 04/12/20 alle ore 16:01:56