Background:Melanoma is the deadliest form of skin cancer and its incidence and mortality vary by sex, age, race, and socioeconomic status. Relatively few studies, however, have characterized disparities in survival improvement across these demographic groups in melanoma. Methods: Survival data from the Surveillance, Epidemiology, and End Results (SEER) database were obtained from 2004 to 2018. The compiled data were analyzed for cancer-specific survival (CSS) to produce multivariable Cox regressions that estimate sex-based survival disparities across patient demographic groups. Additionally, time-to-progression and survival analyses were conducted for a cohort of patients with carcinoma-in situ (CIS) that developed into melanoma. Results: In both female and male patients, melanoma diagnosis in more recent years (2014–2018 versus 2004–2008) was associated with an improved CSS, with females demonstrating an HR of 0.55 (95% CI: 0.49–0.60) and males demonstrating an HR of 0.49 (0.46–0.53). The trend remained consistent upon analyzing the effects of both sex and race on survival improvement for White and Hispanic males and females, but the results were not significant for Black and Asian patients. Joint sex and age analysis demonstrated significant reductions in HR across all age groups for female and male patients with a diagnosis in more recent years. Analysis of lesions progressing from CIS to melanoma (high-risk CIS) demonstrated an increased OR for males over females (OR: 1.70; 95% CI: 1.55–1.85), while survival analysis demonstrated no difference between sexes in the HR. Finally, for male patients, high-risk CIS demonstrated worse CSS compared to female patients with high-risk CIS (OR: 1.43; 95% CI: 1.15–1.79). Conclusion: Overall, melanoma survival has improved in recent years, though some patient subgroups have experienced a lower improvement in survival from 2004 to 2018.
背景：黑色素瘤是最致命的皮肤癌类型，其发病率和死亡率因性别、年龄、种族和社会经济地位而异。然而，目前针对黑色素瘤患者在不同人口学群体中生存改善差异的研究相对较少。方法：本研究从监测、流行病学和最终结果（SEER）数据库中获取2004年至2018年的生存数据。通过分析汇总数据的癌症特异性生存率（CSS），建立多变量Cox回归模型以评估不同患者人口学群体中基于性别的生存差异。此外，对一组从原位癌（CIS）进展为黑色素瘤的患者进行了疾病进展时间和生存分析。结果：在女性和男性患者中，近年（2014-2018年 vs 2004-2008年）确诊的黑色素瘤均与CSS改善相关，女性风险比（HR）为0.55（95% CI：0.49-0.60），男性HR为0.49（0.46-0.53）。在分析白人和西班牙裔男女患者的性别与种族对生存改善的联合影响时，该趋势保持一致，但黑人和亚裔患者的结果未达统计学显著性。性别与年龄联合分析显示，所有年龄段的近期确诊患者中，女性和男性的HR均显著降低。对从CIS进展为黑色素瘤（高危CIS）的病灶分析表明，男性比女性的比值比（OR）更高（OR：1.70；95% CI：1.55-1.85），而生存分析显示两性间的HR无差异。最后，与女性高危CIS患者相比，男性高危CIS患者表现出更差的CSS（OR：1.43；95% CI：1.15-1.79）。结论：总体而言，近年来黑色素瘤生存率有所改善，但2004年至2018年间部分患者亚群的生存改善程度较低。
Sex-Based Differences in Melanoma Survival Improvement from 2004 to 2018
肿瘤(癌症)患者之家