This study was performed to determine the characteristics and clinical outcome of patients with cutaneous malignant melanoma in Taiwan. The medical records of patients with primary cutaneous melanoma between 1992 and 2001 at Chang Gung Memorial Hospital (CGMH) were retrieved from the cancer registry. Survival was analysed by the Kaplan-Meier method. Univariate and multivariate analyses of factors associated with survival were performed using the Cox proportional hazard model. One hundred and eighty-one cases were retrieved from the cancer registry of CGMH. The male to female ratio was 1 : 1.13. The most common age of onset was the sixth decade. The median age of onset was 61 years (2-95 years). There were 105 cases (58%) of acral lentiginous melanoma (ALM), 55 cases (30.4%) of nodular melanoma (NM), 19 cases (10.5%) of superficial spreading melanoma (SSM) and two cases (1.1%) of lentigo maligna melanoma. The median survival of the 181 patients was 3.71 years, and the 5-year survival rate was 45.63%. Five-year survival rates of patients with stages I, II, III and IV disease were 84.39%, 56.03%, 34.7% and 0%, respectively. Sex, Breslow thickness, Clark's level, pathological type and age were significant prognostic factors. There were no survival differences between ALM and NM. Both ALM and NM were associated with a poor prognosis when compared with SSM. In conclusion, ALM is the most common type of cutaneous malignant melanoma in Taiwan. The prognostic factors in Taiwan are similar to those in melanoma-prevalent countries.
Progressive sarcopenia after diagnosis of colorectal cancer has a significant negative prognostic association with overall and progression-free survival.
Unexpected fatal events in patients with head and neck cancers undergoing concurrent chemoradiation therapy are a clinical concern. Malnutrition, which is reported frequently in head and neck cancer patients, are associated with immunity derangement. The purpose of this study was to identify risk factors for early death of patients undergoing chemoradiation. We retrospectively analyzed the records of 194 stage III, IVA, and IVB head and neck cancer patients who were treated with chemoradiation between 2007 and 2009. We defined early death as death while receiving chemoradiation or within 60 days of treatment completion. Risk factors for early death were tested using univariate and multivariate analyses. Fourteen patients (7.2 %) experienced early death, 78.6 % of whom died of infection. Univariate analysis revealed significant correlations between early death and several pretreatment variables, including Eastern Cooperative Oncology Group performance status (PS) >1, hemoglobin <10 g/dL, albumin <3 g/dL, body mass index (BMI) <19 kg/m(2), and peripheral blood total lymphocyte count <700/μL. Multivariate analysis showed that PS >1, BMI <19 kg/m(2), and peripheral blood total lymphocyte count <700/μL were independent variables associated with early death. Poor performance status and malnutrition before chemoradiation independently predict early death in locally advanced head and neck cancer patients undergoing chemoradiation. Cautious management of head and neck cancer patients with these risk factors is required throughout chemoradiation period.
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