Abstract
BackgroundThere is no criterion to distinguish synchronous and non-synchronous multiple primary cutaneous melanomas (MPMs). This study aimed to distinguish synchronous and non-synchronous MPMs and compare the survivals of them using the Surveillance, Epidemiology, and End Results database.MethodsSynchronous and non-synchronous MPMs were distinguished by fitting the double log transformed distribution of the time interval between the first and second primary cutaneous melanomas (TIFtS) through a piecewise linear regression. The overall and melanoma-specific survivals were compared by the Kaplan–Meier method and Cox proportional hazard model through modeling the occurrence of synchronous MPMs as a time-dependent variable.ResultsThe distribution of TIFtS was composed by three power-law distributions. According to its first inflection point, synchronous MPMs were defined as tumors that occurred within 2 months. The Kaplain–Meier plot revealed a significant inferior survival for synchronous MPMs than non-synchronous MPMs (P < 0.0001), and the occurrence of synchronous MPM was a risk factor for overall survival of cutaneous melanoma (CM) (hazard ratio: 2.213; (95% CI [2.087–2.346]); P < 0.0001).ConclusionsThis study provided data analysis evidences for using 2 months to distinguish synchronous MPMs and non-synchronous MPMs. Furthermore, the occurrence of synchronous MPM was a risk factor for prognosis of patients with CM.
Highlights
Cutaneous melanoma (CM) is the most lethal type of skin cancer
For the first regression line, the inflection point was at 2 months, and we choose this time point to distinguish synchronous and non-synchronous multiple primary cutaneous melanomas (MPMs)
The second and third distributions were mainly patients with non-synchronous MPMs, our analysis showed a significant enrichment of patients that developed subsequent synchronous MPMs in the second power law distribution than the third distribution (9.1% vs 7.3%, P < 0.0001)
Summary
Cutaneous melanoma (CM) is the most lethal type of skin cancer. The incidence, mortality, and disease burden of CM have been increasing annually (Ali, Yousaf & Larkin, 2013; GBD 2015 Mortality & Causes of Death Collaborators, 2016). Survival between synchronous and non-synchronous multiple primary cutaneous melanomas—a SEER database analysis. There is no criterion to distinguish synchronous and non-synchronous multiple primary cutaneous melanomas (MPMs). This study aimed to distinguish synchronous and non-synchronous MPMs and compare the survivals of them using the Surveillance, Epidemiology, and End Results database. Methods: Synchronous and non-synchronous MPMs were distinguished by fitting the double log transformed distribution of the time interval between the first and second primary cutaneous melanomas (TIFtS) through a piecewise linear regression. Conclusions: This study provided data analysis evidences for using 2 months to distinguish synchronous MPMs and non-synchronous MPMs. the occurrence of synchronous MPM was a risk factor for prognosis of patients with CM
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