BACKGROUND Clinical guidelines for the treatment of melanoma are based largely on the behavior of thicker tumors. As a result, little is known about survival differences among patients with thinner tumors. OBJECTIVE To investigate the variability in survival for American Joint Committee on Cancer stage T1 thin melanoma tumors, defined as tumors less than 1 mm thick at diagnosis. METHODS This population-based series included 43,008 non-Hispanic whites in whom cutaneous melanoma was diagnosed between 2004 and 2013 from the California Cancer Registry. Survival outcomes were estimated using the Kaplan-Meier method. Cox proportional hazard models were used to estimate risk of death. RESULTS Survival for patients with thin ulcerated tumors was comparable to that for patients with stage II tumors, who are currently treated more aggressively. At 12 months, patients with thin ulcerated tumors had approximately 6% lower survival (92.5% [95% confidence interval (CI), 90.6%-93.9%]) compared with patients with thin nonulcerated tumors (98.2% [95% CI, 98.0%-98.3%]). At 24 months, this survival difference increased (85.2% [95% CI, 82.8%-87.4%] vs 96.1% [95% CI, 95.8-96.3%] for those with thin ulcerated and thin nonulcerated tumors, respectively) and a greater than 15% survival difference was seen at 60 months. LIMITATIONS Previous reports of cancer registry data have noted some evidence of miscoding of thin tumors. CONCLUSION The poorer survival in patients with ulcerated tumors less than 1 mm thick implies the need for additional studies to determine potential benefits of more aggressive treatment.

中文翻译：

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薄溃疡黑色素瘤的预后不良以及对更积极的治疗方法的影响。


背景技术黑色素瘤治疗的临床指南主要基于较厚肿瘤的行为。因此，人们对肿瘤较薄的患者的生存差异知之甚少。目的 调查美国癌症联合委员会 T1 期薄黑色素瘤（定义为诊断时厚度小于 1 毫米的肿瘤）的生存变异性。方法 这个基于人群的系列研究包括 43,008 名非西班牙裔白人，他们在 2004 年至 2013 年间从加州癌症登记处被诊断出皮肤黑色素瘤。使用 Kaplan-Meier 方法估计生存结果。 Cox比例风险模型用于估计死亡风险。结果 薄溃疡肿瘤患者的生存率与目前接受更积极治疗的 II 期肿瘤患者相当。 12 个月时，与薄的非溃疡肿瘤患者 (98.2% [95% CI, 98.0]) 相比，薄溃疡肿瘤患者的生存率降低约 6% (92.5% [95% CI, 90.6%-93.9%])。 %-98.3%]）。 24 个月时，这种生存差异增加（薄溃疡肿瘤和薄非溃疡肿瘤患者的生存率分别为 85.2% [95% CI, 82.8%-87.4%] vs 96.1% [95% CI, 95.8-96.3%]） 60 个月时生存率差异超过 15%。局限性 先前的癌症登记数据报告已经注意到一些薄肿瘤编码错误的证据。结论 溃疡性肿瘤厚度小于 1 毫米的患者生存率较差，这意味着需要进行更多研究来确定更积极治疗的潜在益处。