比例ハザードモデルを用いた悪性黒色腫の予後因子の検討
スポンサーリンク
概要
- 論文の詳細を見る
Sixty patients with malignant melanoma were studied. The sex ratio was male 29: female 31. The patient age ranged from 17 to 86 years (mean age, 59.6 years) . The primary tumors were 28 acral lentigenous melanomas, 17 superficial spreading melanomas, 4 nodular melanomas, 3 lentigo maligna melanomas and 2 mucosal melanomas. The level of tumor invasion was identified as II (2 patients), III (6 patients), IV (32 patients) and V (6 patients) . Tumor thickness was distinguished into four groups: less than 0.76mm (4 patients), between 0.76 and 1.50mm (5 patients), between 1.51 and 4.0mm (15 patients) and more than 4.0mm (18 patients) . Using the Kaplan-Meier life table method coupled with the log-rank test, univariate survival analyses were performed for 8 factors (age, sex, treatment history, histologic type of melanoma, level of invasion, tumor thickness, metastases to regional lymph nodes and pathologic stage). These variables other than stage, which was essentially a dependent factor, were further analyzed by the multivariate analytical method of the Cox proportional hazards model in order to determine the primary independent risk factor predicting survival in melanoma patients. The Kaplan-Meier life table method demonstrated the following three factors that worsen patient survival significantly evidence of metastasis to the regional nodes (p<0.0001), advancement of pathologic stage (p=0.021), and advancement of level (p=0.038) . Other factors like patient age, sex, treatment history, tumor thickness or histologic type did not significantly correlate with the patient survival. When the above factors except for stage were applied to the Cox proportional hazards multivariate analysis model, we were able to acquire amodel that significantly fitted the real data (p=0.012) . This model demonstrated that the regional lymph nodes metastasis and level were the variables that significantly reflects patient survival (p=0.017, 0.029 respectively) . Stepwise selection was then performed by removing the least important variable at respective steps until the remaining variables were all significantly important at the p<0.05 level. The regional lymph nodes metastasis and level were the variables that remained at the final step of the selection. The relative death rate (hazard ratio) of the regional lymph nodes metastasis and level were 9.07 and 12.6 respectively. Although tumor thickness has been reported to be the best prognostic indicator, it dose not necessarily predict patient survival when all stages are taken together. The characteristics of our materials may have reached the evidence that tumor thickness was not a significant prognostic factor.
著者
関連論文
- 182 アトピー性疾患患者におけるIL-13の機能性遺伝子多型の解析
- ハンセン病患者の2例
- バージャー病の下腿潰瘍に生じ間葉系腫瘍との鑑別が困難であった低分化有棘細胞癌の1例
- ステップワイズ重回帰分析を用いた悪性黒色腫の予後因子の解析
- 血管肉腫の治療
- ケラチンの免疫組織化学染色パターンが Bulge Area に一致した Trichoblastic Fibroma
- 悪性黒色腫に対する陽子線療法の試みについて
- 比例ハザードモデルを用いた悪性黒色腫の予後因子の検討
- Subtotal integumentectomy を施行した in-transit 転移を有する悪性黒色腫の4例
- Late phase II clinical test of irinotecan hydrochloride (CPT-11) for squamous cell carcinomas and malignant melanomas.
- Eccrine Porocarcinoma : DAPI顕微蛍光測光法による細胞核DNA量解析
- 比例ハザードモデルを用いた悪性黒色腫の予後因子の検討
- 悪性黒色腫細胞核DNA量の標準偏差, 変動係数の予後因子的意義について
- QOL (quality of life) を考慮した悪性黒色腫患者の生存時間解析
- 日光角化症に生じ, 免疫組織化学染色にて悪性外毛根鞘腫と考えられた1例
- Survival time analysis of patient ofmalignant melanoma taking account of QOL (quality of life).
- 前立腺癌の皮膚転移-1症例の報告および筑波大学における内臓癌皮膚転移の統計的観察-
- 巨大腫瘤を呈した熱傷瘢痕有棘細胞癌
- 日光角化症に生じ, 免疫組織化学染色にて悪性外毛根鞘腫と考えられた1例
- Prognostic significance of standard deviation and coefficient of variation of DNA quantity of malignant melanoma cell nucleus.
- 筑波大学皮膚科における悪性黒色腫の統計的観察ならびに予後に関する検討
- Late dermatopathy after proton beam radiation for skin malignant tumor.
- A case of malignant trichilemmoma.
- Eccrine Porocarcinoma.