A great portion of cutaneous melanoma’s diagnoses nowadays is attributed to thin tumors with up to 1 mm in Breslow thickness (hereafter thin CMs), which occasionally metastasize. The objective of this study was to identify thin CM’s metastatic patterns from a topographical and chronological standpoint. A total of 204 cases of metastatic thin CMs from five specialized centers were included in the study, and corresponding data were collected (clinical, epidemiological, histopathological information of primary tumor and the number, anatomical site, and time intervals of their progressions). First progressions occurred locally, in regional lymph nodes, and in a distant site in 24%, 15% and 61% of cases, respectively, with a median time to first progression of 3.10 years (IQR: 1.09–5.24). The median elapsed time between the first and second progression and between the second and third progression was 0.82 (IQR: 0.34–1.97) and 0.49 (IQR: 0.21–2.30) years, respectively, while the median survival time was about 4 years since first progression. Furthermore, the sequences of locations and time intervals of the progressions were associated with the clinicopathological and demographic features of the primary tumors along with the features of the preceding progressions. In conclusion, the findings of this study describe the natural history of thin CMs, thus highlighting the necessity to identify subgroups of thin CMs at a higher risk for metastasis and contributing to the optimization of the management and follow-up of thin CM patients.
如今，大部分皮肤黑色素瘤的诊断归因于厚度不超过1毫米的薄肿瘤（以下简称薄CM），这些肿瘤偶尔会发生转移。本研究的目的是从地理和时间的角度识别薄CM的转移模式。研究共纳入了来自五个专业中心的204例转移性薄CM病例，并收集了相应的数据（原发肿瘤的临床、流行病学、组织病理学信息以及其进展的数量、解剖部位和时间间隔）。首次进展分别发生在局部、区域淋巴结和远处部位的病例比例分别为24%、15%和61%，首次进展的中位时间为3.10年（四分位间距：1.09–5.24）。首次进展与第二次进展之间以及第二次进展与第三次进展之间的中位时间分别为0.82年（四分位间距：0.34–1.97）和0.49年（四分位间距：0.21–2.30），而自首次进展以来的中位生存时间约为4年。此外，进展的部位顺序和时间间隔与原发肿瘤的临床病理和人口统计学特征以及先前进展的特征相关。总之，本研究的结果描述了薄CM的自然史，从而强调了识别高转移风险的薄CM亚组的必要性，并有助于优化薄CM患者的管理和随访。
肿瘤(癌症)患者之家