All primary urinary tract malignant melanoma (ureter vs. bladder vs. urethra) patients were identified from within the Surveillance, Epidemiology, and End Results (SEER) database 2000–2020. Kaplan-Maier plots depicted the overall survival (OS) rates. Univariable and multivariable Cox regression (MCR) models were fitted to test the differences in overall mortality (OM). In the overall cohort (n = 74), the median OS was 22 months. No statistically significant or clinically meaningful differences were recorded according to sex (female vs. male;p= 0.9) and treatment of the primary (endoscopic vs. surgical;p= 0.6). Conversely, clinically meaningful but not statistically significant (p≥ 0.05) differences were recorded according to the patient’s age at diagnosis (≤80 vs. ≥80 years old;p= 0.2), marital status (married 26 vs. unmarried 16 months;p= 0.2), and SEER stage (localized 31 vs. regional 14 months;p= 0.4), and the type of systemic therapy (exposed 31 vs. not exposed 20 months;p= 0.06). Finally, in univariable and MCR analyses, after adjustment for the SEER stage and type of systemic therapy, tumor origin within the bladder was associated with a three-fold higher OM (Hazard ratio: 3.00;p= 0.004), compared to tumor origin within the urethra. In conclusion, primary urinary tract malignant melanoma patients have poor survival. Specifically, tumor origin within the bladder independently predicted a higher OM, even after adjustment for the SEER stage and systemic therapy status.
本研究从2000年至2020年监测、流行病学和最终结果（SEER）数据库中筛选出所有原发性尿路恶性黑色素瘤（输尿管、膀胱、尿道）患者。通过Kaplan-Meier曲线描绘总体生存率，并采用单变量及多变量Cox回归模型检验总体死亡率的差异。在全部74例患者中，中位总体生存期为22个月。根据性别（女性 vs. 男性；p=0.9）及原发灶治疗方式（内镜治疗 vs. 手术治疗；p=0.6）分析，未发现具有统计学意义或临床意义的生存差异。然而，在诊断年龄（≤80岁 vs. ≥80岁；p=0.2）、婚姻状况（已婚26个月 vs. 未婚16个月；p=0.2）、SEER分期（局限性31个月 vs. 区域性14个月；p=0.4）以及全身治疗类型（接受治疗31个月 vs. 未接受20个月；p=0.06）方面，观察到具有临床意义但未达统计学显著性的差异。单变量及多变量分析显示，在调整SEER分期和全身治疗类型后，与尿道起源肿瘤相比，膀胱起源肿瘤的总体死亡率升高三倍（风险比：3.00；p=0.004）。综上所述，原发性尿路恶性黑色素瘤患者预后较差，其中膀胱起源肿瘤在调整分期和全身治疗状态后，仍可独立预测更高的总体死亡率。
肿瘤(癌症)患者之家