评估黑色素瘤脑转移患者的生存率:乳酸脱氢酶的预后价值。

IF 1.5 4区 医学 Q3 DERMATOLOGY
Melanoma Research Pub Date : 2023-10-01 Epub Date: 2023-07-03 DOI:10.1097/CMR.0000000000000907
Giacomo Pelizzari, Elisa Bertoli, Silvia Buriolla, Maria Grazia Vitale, Debora Basile, Lorenza Palmero, Diego Zara, Donatella Iacono, Freschi Andrea, Gaetano Pascoletti, Silvia Bolzonello, Mattia Garutti, Gianpiero Fasola, Fabio Puglisi, Alessandro Marco Minisini
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引用次数: 0

摘要

黑色素瘤脑转移(MBM)患者预后不佳,尽管局部和全身治疗取得了进展。黑色素瘤特异性分级预后评估(GPA)有效地对MBM患者的生存率进行了分层。然而,乳酸脱氢酶(LDH)是黑色素瘤患者的一个众所周知的预后因素,在GPA评分中没有表现出来,可能会增加MBM患者的预后信息。在本研究中,对150例连续的MBM患者进行了回顾性分析,目的是评估MBM患者的独立预后因素,包括LDH。此外,我们根据治疗方式进行了疾病特异性预后评分和估计生存率。在多变量Cox回归分析的基础上,六个预后因素(年龄、BRAF状态、MBM数量、颅外转移部位数量、表现状态和LDH水平)在生存率方面具有统计学意义,并结合预后评分将患者分为不同的预后组(P
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Estimating survival in patients with melanoma brain metastases: prognostic value of lactate dehydrogenase.

Patients with melanoma brain metastases (MBM) have poor prognosis, albeit advances in locoregional and systemic treatments. The melanoma-specific Graded Prognostic Assessment (GPA) effectively stratifies survival for patients with MBM. Nevertheless, lactate dehydrogenase (LDH), a well known prognostic factor for patients with melanoma, is not represented in the GPA scores and might add prognostic information for patients with MBM. In this study, 150 consecutive patients with MBM were retrospectively analyzed with the aim of evaluating independent prognostic factors for MBM patients, including LDH. Furthermore, we implemented a disease-specific prognostic score and estimated survival according to treatment modalities. On the basis of multivariable Cox regression analyses, six prognostic factors (age, BRAF status, number of MBM, number of extracranial metastatic sites, performance status, and LDH level) resulted statistically significant in terms of survival and were combined in a prognostic score to stratify patients in distinct prognostic groups ( P  < 0.0001). Among treatment modalities, a multimodal approach with stereotactic radiosurgery or neurosurgery associated with systemic therapy showed the best outcome (median overall survival: 12.32 months, 95% confidence interval, 7.92-25.30). This is the first study to demonstrate that LDH has independent prognostic value for patients with MBM and might be used to improve prognostic stratification, albeit external validation is mandatory. Survival of patients with MBM is affected by both disease-specific risk factors and treatment modalities, with locoregional treatments associated with better outcomes.

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来源期刊
Melanoma Research
Melanoma Research 医学-皮肤病学
CiteScore
3.40
自引率
4.50%
发文量
139
审稿时长
6-12 weeks
期刊介绍: ​​​​​​Melanoma Research is a well established international forum for the dissemination of new findings relating to melanoma. The aim of the Journal is to promote the level of informational exchange between those engaged in the field. Melanoma Research aims to encourage an informed and balanced view of experimental and clinical research and extend and stimulate communication and exchange of knowledge between investigators with differing areas of expertise. This will foster the development of translational research. The reporting of new clinical results and the effect and toxicity of new therapeutic agents and immunotherapy will be given emphasis by rapid publication of Short Communications. ​Thus, Melanoma Research seeks to present a coherent and up-to-date account of all aspects of investigations pertinent to melanoma. Consequently the scope of the Journal is broad, embracing the entire range of studies from fundamental and applied research in such subject areas as genetics, molecular biology, biochemistry, cell biology, photobiology, pathology, immunology, and advances in clinical oncology influencing the prevention, diagnosis and treatment of melanoma.
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