Tharani Murali, Matthew Schwartz, Adam Z Reynolds, Li Luo, Grace Ridgeway, Klaus J Busam, Anne E Cust, Hoda Anton-Culver, Richard P Gallagher, Roberto Zanetti, Stefano Rosso, Lidia Sacchetto, Colin B Begg, Irene Orlow, Nancy E Thomas, Marianne Berwick
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引用次数: 0
摘要
黑色素瘤的性别差异是显著的，女性具有显著的生存优势。然而，目前还不清楚为什么我们会看到这种生存优势。在这里，我们研究了GEM研究中1753例单一原发性黑色素瘤患者的性别、临床病理变量和黑色素瘤特异性生存率之间的关系。使用Cox比例风险模型和正式的中介分析，性别对生存的影响在很大程度上可以通过诊断时肿瘤临床病理特征的差异来解释。具体来说，我们发现有证据表明，性别对黑色素瘤生存的影响中有86.5%是由诊断年龄、brreslow厚度、溃疡、有丝分裂和部位的差异介导的(HR 1.85， P
Sex differences in melanoma are prominent, with females having a significant survival advantage. However, it is unclear why we see this survival advantage. Here we investigate the relationship between sex, clinicopathologic variables, and melanoma specific survival in 1,753 single primary melanomas from patients in the GEM study. Using Cox proportional hazard models and formal mediation analysis, the effect of sex on survival is explained largely by differences in the clinicopathologic features of tumors at diagnosis. Specifically, we find evidence that 86.5% of the effect of sex on melanoma survival is mediated by differences in age at diagnosis, Breslow thickness, ulceration, mitoses and site (HR 1.85, P < .001). This analysis indicates that the female survival advantage in melanoma is not due primarily to a direct effect of sex (HR 1.19, P = .42) but is largely a result of an indirect effect of sex mediated by clinicopathologic features.
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