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首页> 外文期刊>Nature reviews. Urology >Bladder cancer: Accelerating MVAC
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Bladder cancer: Accelerating MVAC

机译：膀胱癌：加速MVAC

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Transplant recipients are at elevated risk of melanoma and may have poorer outcomes than nontransplant recipients. We conducted a national, population-based, matched cohort study of Australian kidney transplant recipients and randomly selected members of the general population matched for age, sex, state and year of diagnosis with invasive cutaneous melanoma (1982-2003). Melanoma histopathological characteristics were extracted from cancer registry notifications and death data were obtained from the National Death Index (1982-2011). Histopathology was compared using conditional logistic regression and overall survival analyzed using Cox proportional hazard models. Compared to melanomas in nontransplant recipients (n = 202), melanomas in transplant recipients (n = 75) had a higher Clark's level (p = 0.007) and higher American Joint Committee on Cancer pathologic stage (p = 0.002), but not Breslow thickness (p = 0.11). Posttransplant melanoma conferred higher risk of death (adjusted hazard ratio 4.26, 95% CI 2.71-6.72, p < 0.001) after adjustment for the matching variables, pathologic stage, histological type and anatomic site. This was not explained by transplantation alone. Melanomas in transplant recipients are more invasive than those in nonrecipients. More aggressive tumor behavior is also supported by a markedly poorer outcome. Treatment algorithms developed for the general population with melanoma may not apply to transplant recipients. A review of patient education and skin cancer screening guidelines is warranted. In a population-based, matched cohort study of Australian kidney transplant recipients and nonrecipients with melanoma, the authors find that transplantation is associated with a fourfold increased risk of death after controlling for stage and other prognostic factors.
机译：移植受者黑色素瘤的风险较高，并且结果可能比非移植受者更差。我们对澳大利亚的肾脏移植受者进行了全国性，以人群为基础的配对队列研究，并随机选择了年龄，性别，状态和诊断为浸润性皮肤黑色素瘤（1982-2003）的普通人群。黑色素瘤的组织病理学特征是从癌症登记通知中提取的，死亡数据是从国家死亡指数（1982-2011）获得的。使用条件逻辑回归比较组织病理学，并使用Cox比例风险模型分析整体生存率。与非移植受者的黑色素瘤（n = 202）相比，移植受者的黑色素瘤（n = 75）具有更高的Clark's水平（p = 0.007）和较高的美国癌症病理分期联合委员会（p = 0.002），但不包括Breslow厚度（p ＝ 0.11）。调整匹配变量，病理分期，组织学类型和解剖部位后，移植后黑色素瘤具有更高的死亡风险（调整后的危险比4.26，95％CI 2.71-6.72，p <0.001）。这不能仅通过移植来解释。移植受者的黑色素瘤比非接受者的黑色素瘤更具侵入性。明显较差的结果也支持更具侵略性的肿瘤行为。针对一般黑色素瘤人群开发的治疗算法可能不适用于移植接受者。有必要对患者的教育和皮肤癌筛查指南进行审查。在一项基于人群的配对队列研究中，澳大利亚肾脏移植受者和非接受者患有黑色素瘤，作者发现，在控制分期和其他预后因素后，移植与死亡风险增加了四倍有关。

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