The increased survival in malignant cutaneous melanoma (melanoma) is probably due to early diagnosis combined with improved treatment most recently. National health campaigns and screening programs for melanoma detection were started in Sweden several decades ago. We want to assess the influence of tumor characteristics, based on the TNM classification, and of second primary cancers on overall survival in melanoma. We used the Swedish Cancer Registry to assess all‐cause survival in melanoma from 2003 to 2015. Hazard ratios (HRs) were estimated using multivariable Cox regression models. A total of 19,773 melanoma patients were diagnosed with TNM data. Survival showed a strong improving trend over time (p ‐trend <.001). T1a was the most common classification (48.0% of all), while higher T class was associated systematically with worse survival (p ‐trend <.001). For distant metastases, the HR was 3.17, accounting for 0.9% of the patients. Any types of second primary cancers, other than melanoma, were associated with an HR of 2.00, accounted for 6.7% of all cases. Even if melanoma survival in Sweden ranks among the best national rates, the large percentage of patients with advanced tumors (T3b, T4a, and T4b, 17%) and 21% of deaths with T1a call for improved preventive and follow‐up strategies.

中文翻译：

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肿瘤特征与第二原发癌与皮肤黑色素瘤存活之间的关联：一项全国性队列研究。

恶性皮肤黑色素瘤（黑色素瘤）存活率的提高可能是由于早期诊断和最近的改良治疗所致。几十年前，瑞典开始了全国健康运动和黑素瘤检测筛查计划。我们要根据TNM分类评估肿瘤特征的影响以及第二原发癌对黑色素瘤总体生存的影响。我们使用瑞典癌症注册中心评估了2003年至2015年黑色素瘤的全因生存率。使用多变量Cox回归模型估算了危险比（HRs）。共有19,773名黑色素瘤患者被诊断为TNM数据。随着时间的推移，生存率呈现出强劲的改善趋势（p趋势<.001）。T1a是最常见的分类（占所有分类的48.0％），而较高的T级则与较差的生存系统相关（p趋势<.001）。对于远处转移，HR为3.17，占患者的0.9％。除黑色素瘤外，任何类型的第二原发癌的HR均为2.00，占所有病例的6.7％。即使瑞典的黑色素瘤生存率在全国范围内名列前茅，但患有晚期肿瘤（T3b，T4a和T4b，17％）和21％T1a死亡的患者中，仍有很大比例需要改善预防和随访策略。