Revista Finlay (Jan 2021)

Mortality Prognostic Factors in Patients with Cutaneous Malignant Melanoma

  • Víctor Ernesto González Velázquez,
  • Lázaro Roque Pérez,
  • Elys María Pedraza Rodríguez,
  • Lissi Lisbet Rodríguez Rodríguez,
  • Mabel González Escudero

Journal volume & issue
Vol. 11, no. 1
pp. 10 – 22

Abstract

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Background: cutaneous malignant melanoma is the most lethal skin tumor, so it is important to know the risk factors for mortality in patients who suffer from it. Objective: to determine the prognostic factors of mortality in patients with cutaneous malignant melanoma diagnosed and treated at the Celestino Hernández Robau Teaching University Hospital between January 2010 and December 2015. Method: a retrospective cohort analytical observational study was carried out. The population consisted of all patients with cutaneous malignant melanoma diagnosed and treated at the Hospital in the study period (N = 142), and the sample was 112 patients. The variables analyzed were: age, sex, skin color, histological subtype, Breslow index, Clark level, mitotic index, lymph node involvement, distant metastasis, ulceration, topographic location, clinical stage, type of treatment, and lactate dehydrogenase levels blood at diagnosis. The Odds Ratio (OR) and its confidence intervals (CI) were determined for the statistically significant factors. The area under the ROC curve was evaluated for the quantitative variables and a multivariate analysis was performed using Binary Logistic Regression. It was a reliability of 95 %. Results: the multivariate analysis identified as prognostic factors of mortality the Breslow index with a C statistic of 0.849 (CI: 0.770–0.923), the Clark V level (OR: 1.246; CI: 0.985-1.870), mitotic index ≥ 6mm2 (OR: 12.408; CI: 9.012-14.897), lymph node involvement ≥ 2 nodes (OR = 6.316; CI = 4.541-8.291), metastasis to lung or other viscera (OR: 6.206; CI: 4.342-8.001), tumor location on the head, neck or trunk (OR: 9.720; CI: 7.684-12.546), ulceration (OR: 0.528; CI: 0.120-0.856), non-surgical treatment (OR: 8.311; CI: 7.098-9.366) and the LDH value in blood ≥333 IU / l (OR: 18.905; CI: 14.750-21.053). Conclusions: the prognostic factors of mortality in patients with a diagnosis of cutaneous malignant melanoma were the Breslow index, the Clark level, the mitotic index, lymph node involvement, metastases to the lung or other viscera, the location of the tumor in the head, neck or trunk, the presence of ulceration, non-surgical treatment and the highest values of LDH in blood.

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