Clinical characteristics and prognostic factors in patients with malignant melanoma: A Chinese prospective cohort study.

Abstract

Background: Melanoma is a highly malignant tumor that has an extremely poor prognosis. It is the primary cause of death among cutaneous malignancies, accounting for 75% of such fatalities; approximately 325000 new cases and 57000 deaths were reported worldwide in 2020. The main modalities for melanoma treatment include surgery, immunotherapy, targeted therapy, high-dose interferon, antitumor angiogenesis, chemotherapy, and radiotherapy. Due to China's special national conditions, the main pathological types and therapeutic effects are greatly different from those in Europe and the United States, so more studies are needed to determine the curative effects of such treatments in the Chinese population.

Aim: To explore their clinical characteristics, prognostic influencing factors and real-world data to provide a reference basis for further diagnosis and treatment.

Methods: We collected pathological data from patients diagnosed with malignant melanoma in our hospital in recent years. Univariate analysis was conducted using the log-rank test, while multivariate analysis was performed with the Cox proportional hazard regression model. The survival rate was calculated using the Kaplan-Meier method.

Results: The male-to-female patient ratio was 1.04: 1. Among the clinical classifications, melanoma of the limb accounted for 47.56% of cases, followed by melanoma of the skin (18.18%) and mucosal melanoma (18.05%). The 5-year survival rates for stage I-II, stage III, and stage IV patients were 54.65%, 37.88%, and 28.58%, respectively. Univariate analysis revealed that age, tumor stage, treatment mode, platelet count at the first visit, and lactate dehydrogenase (LDH) level were significantly related to patient survival. Patients with high LDH and high platelet counts exhibited significantly lower survival rates at 1 year, 3 years, and 5 years. Multivariate analysis demonstrated that tumor stage, chemotherapy, interferon therapy, and LDH level were independent risk factors affecting patient survival and prognosis. Compared to the mortality rates of patients who did not receive chemotherapy or interferon therapy, those of patients who received chemotherapy and interferon therapy were 30.0% and 44.5% lower, respectively. Additionally, patients with elevated LDH levels were 2.27 times more likely to die than patients with normal LDH levels.

Conclusion: Melanoma is highly malignant, and its prognosis is influenced by numerous factors, resulting in an overall poor prognosis. This study identified several factors that impact patient prognosis, providing a foundation for individualized comprehensive treatment.