Current Issue
Spring/Summer 2025, Vol. 32 No. 1
Hong Kong J. Dermatol. Venereol. (2025) 32, 20-40
Original Article
Analysis and prediction of risk factors for metastatic melanoma in different sites based on the SEER database
基於SEER數據庫不同部位轉移性黑色素瘤危險因素的分析與預測
R Chen 陳銳慶, H Yu 餘海, WK Ming 明偉傑, X Zheng 鄭炘凱, Y Lin 林鈺, J Lyu 呂軍, L Deng 鄧列華
Abstract
Objective: The aim of this study is to investigate the risk factors associated with metastasis to various sites in melanoma, construct corresponding nomograms for predicting the risk of metastasis, and provide a reference for clinical practitioners in the diagnosis and treatment of this condition. Methods: Utilising SEER database data, we analysed 11,218 metastatic melanoma patients using logistic regression to identify metastasis determinants to bone, brain, liver, and lung, illustrated with a forest plot and developed an interactive nomogram for prediction. Additionally, we investigated prognostic factors for outcomes using the same statistical methods. Results: Our results indicate that histological behaviour, sex, race, marital status, tumour site, surgery at the primary site, postoperative lymph node dissection, and radiotherapy are independent predictors of brain metastasis; histological behaviour, sex, race, marital status, surgery at the primary site, radiotherapy, chemotherapy, Breslow thickness, and ulceration are independent predictors of bone metastasis; histological behaviour, race, marital status, tumour site, surgery at the primary site, postoperative lymph node dissection, chemotherapy, Breslow thickness, and ulceration are independent predictors of liver metastasis; and histological behaviour, age, sex, race, marital status, tumour site, surgery at the primary site, postoperative lymph node dissection, radiotherapy, chemotherapy, and ulceration are independent predictors of lung metastasis. We constructed interactive nomograms based on these factors to predict the probability of metastasis at different sites. Additionally, univariate and multivariate logistic regression analyses revealed that histological behaviour, age, sex, race, marital status, income, tumour size, tumour site, surgery at the primary site, radiotherapy, chemotherapy, Breslow thickness, and ulceration are factors influencing metastatic melanoma. Conclusions: This study has successfully established a nomogram for predicting metastatic melanoma. Among the factors influencing metastasis to various sites, histological behaviour, race, marital status, primary site surgery, and postoperative lymph node dissection were identified as common determinants. This suggests that these factors play a significant role in the metastasis of melanoma. Moreover, these factors also play a crucial role in affecting the prognosis. Therefore, in the clinical diagnosis and treatment process, it is imperative to consider these factors carefully and to analyse them according to the specific circumstances of different patients.
目的：本研究旨在探討黑色素瘤不同部位轉移相關的危險因素，建立相應的列線圖，預測其轉移風險，為臨床醫生診斷和治療該疾病提供參考。方法：利用SEER數據庫數據，我們使用邏輯回歸分析了11,218例轉移性黑色素瘤患者，以確定骨、腦、肝和肺的轉移決定因素，製作森林圖，並開發了用於預測的互動式列線圖。結果：我們的研究結果表明，組織學行為、性別、種族、婚姻狀況、腫瘤部位、原發部位手術、術後淋巴結清掃和放療是腦轉移的獨立預測因素；組織學行為、性別、種族、婚姻狀況、原發部位手術、放療、化療、Breslow厚度和潰瘍是骨轉移的獨立預測因素；組織學行為、種族、婚姻狀況、腫瘤部位、原發部位手術、術後淋巴結清掃、化療、Breslow厚度和潰瘍是肝轉移的獨立預測因素；組織學行為、年齡、性別、種族、婚姻狀況、腫瘤部位、原發部位手術、術後淋巴結清掃、放療、化療和潰瘍是肺轉移的獨立預測因素。基於這些因素，我們建立了互動式列線圖來預測不同部位轉移的概率。此外，單因素和多因素邏輯回歸分析顯示，組織學行為、年齡、性別、種族、婚姻狀況、收入、腫瘤大小、腫瘤部位、原發部位手術、放療、化療、Breslow厚度和潰瘍是影響轉移性黑色素瘤的因素。結論：本研究成功建立了預測轉移性黑色素瘤的列線圖。在影響不同部位轉移的因素中，組織學行為、種族、婚姻狀況、原發部位手術和術後淋巴結清掃是共同的決定因素。這表明這些因素在黑色素瘤的轉移中起重要作用。此外，這些因素在影響預後方面也起著至關重要的作用。因此，在臨床診斷和治療過程中，必須認真考慮這些因素，並根據不同患者的具體情況進行分析。
Keywords: Bone metastasis, Brain metastasis, Liver metastasis, Lung metastasis, Metastatic melanoma, Risk factors
關鍵詞: 骨轉移、腦轉移、肝轉移、肺轉移、轉移性黑色素瘤、危險因素
