Sleep-Disordered Breathing Is Independently Associated With Increased Aggressiveness of Cutaneous Melanoma A Multicenter Observational Study in 443 Patients

被引：50

作者：

Angel Martinez-Garcia, Miguel ^{[1
]}

Campos-Rodriguez, Francisco ^{[2
]}

Nagore, Eduardo ^{[3
]}

Martorell, Antonio ^{[4
]}

Luis Rodriguez-Peralto, Jose ^{[5
]}

Riveiro-Falkenbach, Erica ^{[5
]}

Hernandez, Luis ^{[6
]}

Banuls, Jose ^{[7
]}

Arias, Eva ^{[8
]}

Ortiz, Pablo ^{[9
]}

Cabriada, Valentin ^{[10
]}

Gardeazabal, Jose ^{[11
]}

Maria Montserrat, Josep ^{[12
,33
]}

Carrera, Cristina ^{[13
]}

Corral, Jaime ^{[14
,33
]}

Masa, Juan Fernando ^{[14
]}

Gomez de Terreros, Javier ^{[14
,33
]}

Abad, Jorge ^{[15
]}

Boada, Adam ^{[16
]}

Mediano, Olga ^{[17
,33
]}

de Eusebio, Esther ^{[18
]}

Chiner, Eusebi ^{[19
]}

Landete, Pedro ^{[19
]}

Mayos, Mercedes ^{[20
,33
]}

Fortuna, Ana ^{[20
,33
]}

Barbe, Ferran ^{[21
,33
]}

Sanchez de la Torre, Manuel ^{[21
,33
]}

Sanchez de la Torre, Alicia ^{[21
,33
]}

Cano, Irene ^{[22
]}

Gonzalez, Cristina ^{[23
]}

Perez-Gil, Amalia ^{[24
]}

Gomez-Garcia, Teresa ^{[25
,33
]}

Cullen, Daniela ^{[26
]}

Somoza, Maria ^{[27
]}

Formigon, Manuel ^{[28
]}

Aizpuru, Felipe ^{[29
]}

Navarro, Cristina ^{[1
]}

Jose Selma-Ferrer, Maria ^{[1
]}

Garcia-Ortega, Alberto ^{[1
]}

de Unamuno, Blanca ^{[30
]}

Almendros, Isaac ^{[31
,33
]}

Farre, Ramon ^{[31
,33
]}

Gozal, David ^{[32
]}

机构：

[1] Hosp Univ & Politecn La Fe, Resp Dept, Valencia, Spain

[2] Hosp Valme, Resp Dept, Seville, Spain

[3] Inst Valenciano Oncol, Dermatol Dept, Valencia, Spain

[4] Hosp Manises, Dermatol Dept, Valencia, Spain

[5] Hosp Univ 12 Octubre, Anat Pathol Dept, Madrid, Spain

[6] Hosp Gen Univ Alicante, Resp Dept, Alicante, Spain

[7] Hosp Gen Univ Alicante, Dermatol Dept, Alicante, Spain

[8] Hosp Univ 12 Octubre, Resp Dept, Madrid, Spain

[9] Hosp Univ 12 Octubre, Dermatol Dept, Madrid, Spain

[10] Hosp Univ Cruces Bilbao, Resp Dept, Bilbao, Spain

[11] Hosp Univ Cruces Bilbao, Dermatol Dept, Bilbao, Spain

[12] Hosp Clin IDIBAPS, Resp Dept, Barcelona, Spain

[13] Hosp Clin IDIBAPS, Dermatol Dept, Barcelona, Spain

[14] Hosp Univ San Pedro de Alcantara, Resp Dept, Caceres, Spain

[15] Hosp Univ Germans Trials I Pujol, Resp Dept, Barcelona, Spain

[16] Hosp Univ Germans Trials I Pujol, Dermatol Dept, Barcelona, Spain

[17] Hosp Univ Gen Guadalajara, Resp Dept, Guadalajara, Spain

[18] Hosp Univ Gen Guadalajara, Dermatol Dept, Guadalajara, Spain

[19] Hosp Univ San Juan de Alicante, Resp Dept, Alicante, Spain

[20] Hosp Univ Santa Creu & St Pau, Resp Dept, Barcelona, Spain

[21] IRBLleida, Resp Dept, Lleida, Spain

[22] Hosp Univ Getafe, Resp Dept, Madrid, Spain

[23] Hosp Univ Getafe, Dermatol Dept, Madrid, Spain

[24] Hosp Valme, Dermatol Dept, Seville, Spain

[25] Fdn Jimenez Diaz, Resp Dept, Madrid, Spain

[26] Fdn Jimenez Diaz, Dermatol Dept, Madrid, Spain

[27] Consorcio Sanitario Terrassa, Resp Dept, Barcelona, Spain

[28] Consorcio Sanitario Terrassa, Dermatol Dept, Barcelona, Spain

[29] Univ Basque Country, OSI Araba Univ Hosp, Basque Hlth Serv, Biostat Serv,Hlth Res Inst,Bioaraba, Bilbao, Spain

[30] Hosp Univ & Politecn la Fe, Dermatol Dept, Valencia, Spain

[31] Univ Barcelona, Fac Med & Ciencies Salut, Unitat Biofis & Bioengn, Barcelona, Spain

[32] Univ Chicago, Dept Pediat, Chicago, IL 60637 USA

[33] CIBER Enfermedades Resp, CIBERes, Madrid, Spain

来源：

CHEST | 2018年 / 154卷 / 06期

关键词：

Breslow index; melanoma aggressiveness; sleep apnea; sleep-disordered breathing; CANCER INCIDENCE; BREAST-CANCER; APNEA; TUMOR; PROGRESSION; DURATION; RISK; PREVALENCE; MORTALITY; HEALTH;

D O I：

10.1016/j.chest.2018.07.015

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

BACKGROUND: Sleep-disordered breathing (SDB) has been associated with a greater incidence and mortality of cancer, although such findings are inconsistent. However, no large studies are currently available to investigate this association in patients with a specific type of cancer. This study seeks to assess potential relationships between SDB severity and aggressiveness markers of cutaneous melanoma. METHODS: Four hundred and forty-three patients with a diagnosis of melanoma underwent a sleep study within 6 months of diagnosis. General demographics were collected, along with melanoma characteristics and polygraphic parameters consisting of the apnea-hypopnea index (AHI) and indices of both continuous and intermittent night-time oxyhemoglobin desaturation (DI4%). An exploration of independent relationships between SDB and various objective melanoma aggressiveness markers (Breslow index, presence of ulceration, presence of regression, mitotic index, stage of severity, damage to the sentinel lymph, and spreading of the melanoma) was performed. RESULTS: Patients in the upper tertiles of AHI or DI4% were 1.94 (95% CI, 1.14-3.32; P = .022) and 1.93 (95% CI, 1.14-3.26; P = .013) times more likely, respectively, to present with aggressive melanoma (Breslow index > 1 mm) than those in the lowest tertiles of these sleep attributes after adjustment for age, sex, tumor location, and BMI. This association was particularly prominent among patients < 56 years of age with Breslow index > 2 mm. The presence of the additional markers of aggressiveness was also associated with higher AHI and DI4% values. CONCLUSIONS: The severity of SDB was independently associated with greater aggressiveness of cutaneous melanoma, particularly among younger patients.

引用

页码：1348 / 1358

页数：11

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