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首页> 外文期刊>BMC Cancer >Melanoma-specific mortality and competing mortality in patients with non-metastatic malignant melanoma: a population-based analysis
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Melanoma-specific mortality and competing mortality in patients with non-metastatic malignant melanoma: a population-based analysis

机译：非转移性恶性黑色素瘤患者的黑色素瘤特异性死亡率和竞争性死亡率：基于人群的分析

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Background The objectives of this study were to evaluate and model the probability of melanoma-specific death and competing causes of death for patients with melanoma by competing risk analysis, and to build competing risk nomograms to provide individualized and accurate predictive tools. Methods Melanoma data were obtained from the Surveillance Epidemiology and End Results program. All patients diagnosed with primary non-metastatic melanoma during the years 2004–2007 were potentially eligible for inclusion. The cumulative incidence function (CIF) was used to describe the probability of melanoma mortality and competing risk mortality. We used Gray’s test to compare differences in CIF between groups. The proportional subdistribution hazard approach by Fine and Gray was used to model CIF. We built competing risk nomograms based on the models that we developed. Results The 5-year cumulative incidence of melanoma death was 7.1?%, and the cumulative incidence of other causes of death was 7.4?%. We identified that variables associated with an elevated probability of melanoma-specific mortality included older age, male sex, thick melanoma, ulcerated cancer, and positive lymph nodes. The nomograms were well calibrated. C-indexes were 0.85 and 0.83 for nomograms predicting the probability of melanoma mortality and competing risk mortality, which suggests good discriminative ability. Conclusions This large study cohort enabled us to build a reliable competing risk model and nomogram for predicting melanoma prognosis. Model performance proved to be good. This individualized predictive tool can be used in clinical practice to help treatment-related decision making.
机译：背景技术这项研究的目的是通过竞争风险分析评估和建模黑素瘤患者特定于黑素瘤的死亡和竞争性死亡原因，并建立竞争风险列线图以提供个性化且准确的预测工具。方法从监测流行病学和最终结果程序中获得黑素瘤数据。 2004-2007年期间所有诊断为原发性非转移性黑色素瘤的患者均可能符合纳入条件。累积发生率函数（CIF）用于描述黑色素瘤死亡率和竞争风险死亡率的可能性。我们使用了Gray的检验来比较各组之间CIF的差异。使用Fine和Gray的比例子分布危险度方法对CIF进行建模。我们根据开发的模型构建了竞争风险列线图。结果黑色素瘤死亡的5年累积发生率是7.1％，其他死因的累积发生率是7.4％。我们发现与黑色素瘤特定死亡率升高的可能性相关的变量包括老年，男性，浓厚的黑色素瘤，溃疡性癌和阳性淋巴结。列线图已经很好地校准。诺法图的C指数分别为0.85和0.83，预测黑素瘤死亡率和竞争风险死亡率的可能性，这表明其具有良好的判别能力。结论这项大型研究队列使我们能够建立可靠的竞争风险模型和列线图，以预测黑色素瘤的预后。模型性能证明是好的。这种个性化的预测工具可用于临床实践，以帮助进行与治疗有关的决策。

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