Navegando por Palavras-chave "Melanoma Amelanótico"

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    Histopatologia E Sobrevida De Melanomas Primários Amelanóticos E Pigmentados Tese
    (Universidade Federal de São Paulo (UNIFESP), 2017-12-29) Santos Filho, Ivan Dunshee De Abranches Oliveira [UNIFESP]; Ferreira, Lydia Masako [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Background: The absence of pigmentation in melanomas may lead to a delay in diagnosis and a worse prognosis. There are no studies comparing amelanotic melanoma with pigmented melanoma using the propensity score. Objective: Analyze histopathological characteristics, disease free interval and survival in patients with amelanotic and pigmented melanoma. Methods: A search was performed from 1991 to 2010. Primary melanomas were defined as amelanotic based on histopathology and compared with pigmented melanomas. Using the propensity score, a control (pigmented) group was created, ensuring a balance between the two groups. Univariate and multivariate Cox regression were performed to identify predictors of overall survival and disease free interval. Results: There were 464 cases of amelanotic melanoma and 21,697 pimented melanoma, thus an incidence of 2.1%. Amelanotic melanoma was more common in elderly individuals (odds ratio (OR) = 1.42 older than 65), more associated with primary head and neck tumors (OR = 1.73), greater Breslow thickness (OR = 3.71 above 2 mm), ulceration (OR = 3.26), mitoses (OR = 5.76), and the following subtypes: nodular, acral and desmoplastic (OR = 3.84, 2.74 and 2.58 respectively).On multivariate regression there was no difference in the disease free interval (Hazard Ratio = 0.83, 95% CI = 0.66, 1.05, p = 0.13), but patients with amelanotic melanoma had a better overall survival (Hazard Ratio = 0.76, 95% CI = 0.60, 0.96, p = 0.02) compared to pigmented. Conclusion: Amelanotic melanoma presented the same histopathological characteristics previously described in the literature. Patients with amelanotic melanoma had a better survival when compared to pigmented melanoma.