Clinical characteristics and prognostic factors in patients with malignant melanoma: A Chinese prospective cohort study

Table 1 Clinical characteristics of patients with malignant melanoma

Variable	n (%)	Variable	n (%)	Variable	n (%)	Variable	n (%)
Age (years)		Tumor stage		Types of health insurance		Use of interferon
≤ 50	206 (27.14)	Ⅰ-Ⅱ	172 (22.66)	Resident health insurance	410 (54.02)	No	662 (87.22)
51-70	404 (53.23)	Ⅲ	166 (21.87)	Employee health insurance	206 (27.14)	Yes	96 (12.65)
≥ 71	149 (19.63)	Ⅳ	250 (32.94)	Self-funded and others	143 (18.84)	Use of anti-tumor angiogenic drugs
Sex		Radiotherapy		Clinical classification		No	724 (95.39)
Female	373 (49.14)	No	643 (84.72)	Cutaneous	138 (18.18)	Yes	34 (4.48)
Male	386 (50.86)	Yes	116 (15.28)	Acral	361 (47.56)	Operation
Marriage		Chemotherapy		Mucosal	137 (18.05)	No	228 (30.04)
Married	697 (91.83)	No	481 (63.37)	Ocular	33 (4.35)	Yes	531 (69.96)
Others	62 (8.17)	Yes	278 (36.63)	Types of undetermined origin	90 (11.86)	Platelets*
Underlying diseases1		Immunotherapy		Combined with other tumors		Normal	645 (84.98)
No	625 (82.35)	No	634 (83.53)	No	736 (96.97)	Low	75 (9.88)
Yes	134 (17.65)	Yes	124 (16.34)	Yes	23 (3.03)	High	28 (3.69)
Ethnicity		Targeted therapy		Use of interleukins		Lactate dehydrogenase2
Han	739 (97.36)	No	728 (95.92)	No	711 (93.68)	Normal	493 (64.95)
Others	20 (2.64)	Yes	30 (3.95)	Yes	47 (6.19)	Low	6 (0.79)
						High	134 (17.65)

¹Normal platelet range: 125-350 × 10⁹/L, low is below 125 × 10⁹/L, high is above 350 × 10⁹/L.

²Normal lactate dehydrogenase range: 120-250 U/L; low is less than 120 U/L; high is greater than 250 U/L.

One patient lacked data on the use of interferon therapy, antiangiogenic drugs, interleukin therapy, immunotherapy and targeted therapy.

Table 2 Univariate analysis of prognostic factors in patients with malignant melanoma

Variable	Number of death (%)	Mean survival (months) (95%CI)	Median survival (months) (95%CI)	Survival rate (%)			χ2	P value
				1 year	3 years	5 years
Age (years)							17.757	< 0.001
≤ 50	65 (31.55)	57.65 (50.06, 65.24)	87.3 (35.31, 139.29)	78.80	61.03	52.87
51-70	159 (39.36)	50.28 (44.99, 55.57)	37.4 (28.56, 46.24)	77.00	51.92	39.31
≥ 71	74 (49.66)	32.06 (26.17, 37.96)	20.6 (11.26, 29.94)	76.11	36.70	14.68
Sex							0.000	0.988
Female	147 (39.41)	50.07 (44.51, 55.64)	37.4 (28.94, 45.86)	75.14	52.51	39.68
Male	151 (39.12)	48.36 (43.28, 53.44)	37.4 (26.74, 48.06)	79.01	50.75	37.80
Marriage							1.512	0.219
Married	270 (38.74)	51.05 (47.02, 55.09)	37.4 (30.31, 44.49)	77.48	52.64	52.64
Others	28 (45.16)	40.74 (29.29, 52.19)	32.6 (14.22, 50.98)	71.11	42.10	31.57
Ethnicity							0.003	0.960
Han	289 (39.11)	49.6 (45.53, 53.67)	37.4 (30.94, 43.86)	77.09	52.00	38.91
Others	9 (45.00)	46.73 (28.89, 64.58)	15.8 (0, 0)	71.79	47.86	47.86
Types of health insurance							3.290	0.193
Resident health insurance	163 (39.76)	49.98 (44.82, 55.13)	37.6 (29.2, 46)	76.98	52.74	36.35
Employee health insurance	87 (42.23)	44.17 (37.26, 51.08)	29 (17.3, 40.7)	73.27	44.50	37.15
Self-funded and others	48 (33.57)	50.99 (43.58, 58.4)	59.9 (0, 0)	81.06	56.68	45.30
Clinical type classification							4.172	0.383
Cutaneous	49 (35.51)	49.74 (42.04, 57.43)	47.7 (28.89, 66.51)	77.93	57.12	38.88
Acral	135 (37.4)	49.09 (43.74, 54.45)	37 (28.86, 45.14)	82.51	50.95	37.34
Mucosal	59 (43.07)	49.05 (40.16, 57.94)	36.4 (20.62, 52.18)	68.52	48.93	39.63
Ocular	16 (48.48)	42.6 (27.18, 58.01)	27.7 (0, 67.66)	62.04	47.27	31.51
Types of undetermined origin	39 (43.33)	43.22 (34.05, 52.39)	29 (10.84, 47.16)	66.11	45.08	34.88
Combined with other tumors							0.027	0.870
No	289 (39.27)	49.55 (45.39, 53.71)	37.4 (30.44, 44.36)	77.07	51.63	38.77
Yes	9 (39.13)	47.75 (28.64, 66.86)	35.5 (12.09, 58.91)	78.94	48.58	36.43
Underlying Diseases							7.586	0.006
No	238 (38.08)	52.26 (47.85, 56.67)	41 (34.35, 47.65)	77.68	54.93	41.70
Yes	60 (44.78)	33.79 (27.1, 40.47)	22.9 (13.43, 32.37)	71.63	33.97	19.51
Tumor stage							52.591	< 0.001
Ⅰ-Ⅱ	38 (22.09)	68.03 (59.42, 76.64)	0 (0, 0)	88.31	69.98	54.65
Ⅲ	53 (31.93)	52.34 (43.72, 60.97)	43.1 (29.83, 56.37)	82.02	53.95	37.88
Ⅳ	125 (50.00)	33.85 (28.46, 39.23)	15.1 (11.71, 18.49)	58.04	36.67	28.58
Surgical operation							18.223	0.000
No	118 (51.75)	39.6 (33.46, 45.74)	25.9 (18.66, 33.14)	69.78	41.02	26.25
Yes	180 (33.90)	53.42 (48.62, 58.23)	46.2 (33.23, 59.17)	79.77	56.56	44.09
Radiotherapy							0.010	0.921
No	244 (37.95)	49.6 (45.49, 53.7)	37.3 (29.91, 44.69)	77.11	52.14	38.69
Yes	54 (46.55)	47.83 (39.23, 56.44)	37.8 (24.61, 50.99)	76.17	50.86	39.29
Chemotherapy							3.054	0.081
No	192 (39.92)	45.07 (40.43, 49.71)	34 (28.27, 39.73)	76.92	48.32	33.86
Yes	106 (38.13)	54.8 (48.55, 61.06)	43.1 (27, 59.2)	76.52	56.53	44.52
Immunotherapy							1.637	0.441
No	264 (41.64)	50.25 (46.07, 54.44)	37.6 (30.82, 44.38)	77.01	52.81	39.28
Yes	34 (27.42)	28.44 (23.16, 33.71)	23 (15.5, 30.5)	73.91	39.06	39.06
Targeted therapy							1.042	0.594
No	290 (39.84)	49.58 (45.5, 53.67)	37.3 (30.73, 43.87)	76.86	51.62	38.32
Yes	8 (26.67)	52.36 (34.14, 70.58)	80.5 (0, 0)	76.06	57.04	57.04
Use of interleukins							0.877	0.645
No	276 (38.82)	49.67 (45.47, 53.87)	37.3 (30.33, 44.27)	76.60	51.46	39.24
Yes	22 (46.81)	46.19 (35.54, 56.84)	39.5 (25.55, 53.45)	83.72	52.64	19.19
Use of interferon							3.320	0.068
No	265 (40.03)	46.94 (42.73, 51.15)	36.9 (29.84, 43.96)	75.77	51.00	37.53
Yes	33 (34.38)	58.46 (48.01, 68.9)	59.9 (35.1, 84.7)	84.27	57.77	46.36
Use of antiangiogenic drugs							0.796	0.672
No	284 (39.23)	49.63 (45.53, 53.73)	37.3 (30.54, 44.06)	77.67	51.53	39.07
Yes	14 (41.18)	45.6 (31.17, 60.04)	39.8 (14.15, 65.45)	65.42	50.10	41.75
Platelet count							16.627	< 0.001
Normal	245 (37.98)	49.8 (45.27, 54.32)	37.4 (29.97, 44.83)	78.13	52.27	38.93
Low	30 (40.00)	55.91 (44.92, 66.9)	42.9 (0, 0)	75.13	54.27	48.24
High	14 (50.00)	16.57 (9.99, 23.16)	10.5 (5.35, 15.65)	38.93	29.20	29.20
Lactate dehydrogenase							50.549	< 0.001
Normal	169 (34.28)	53 (48.26, 57.73)	44.6 (31.79, 57.41)	83.14	57.15	43.64
Low	2 (33.33)	43.96 (27.04, 60.88)	42.9 (0, 86.94)	80.00	40.00	40.00
High	70 (52.24)	30.07 (21.38, 38.77)	12.4 (7.35, 17.45)	50.99	29.40	16.38

The raw data were absent for platelet count in 11 patients and for lactate dehydrogenase level in 126 patients.

Table 3 Multifactor analysis of factors affecting prognosis in patients with malignant melanoma

Variable	β	SE	Wald	P value	HR (95%CI)
Tumor stage			31.402	0.000
Ⅰ-Ⅱ					1
Ⅲ	0.459	0.232	3.912	0.048	1.582 (1.004-2.492)
Ⅳ	1.107	0.211	27.455	0.000	3.025 (1.999-4.576)
Chemotherapy (control group = no)	-0.362	0.158	5.239	0.022	0.696 (0.511-0.949)
Interferon therapy (control group = no)	-0.588	0.240	5.999	0.014	0.555 (0.347-0.889)
Lactate dehydrogenase			23.638	0.000
Normal					1
Low	0.788	0.728	1.172	0.279	2.199 (0.528-9.163)
High	0.819	0.171	22.825	0.000	2.267 (1.621-3.172)