Sleep-Disordered Breathing Is Independently Associated With Increased Aggressiveness of Cutaneous Melanoma A Multicenter Observational Study in 443 Patients
Por:
Martinez-Garcia, MA, Campos-Rodriguez, F, Nagore, E, Martorell, A, Rodriguez-Peralto, JL, Riveiro-Falkenbach, E, Hernandez, L, Banuls, J, Arias, E, Ortiz, P, Cabriada, V, Gardeazabal, J, Montserrat, JM, Carrera, C, Corral, J, Masa, JF, de Terreros, JG, Abad, J, Boada, A, Mediano, O, de Eusebio, E, Chiner, E, Landete, P, Mayos, M, Fortuna, A, Barbe, F, de la Torre, MS, de la Torre, AS, Cano, I, Gonzalez, C, Perez-Gil, A, Gomez-Garcia, T, Cullen, D, Somoza, M, Formigon, M, Aizpuru, F, Navarro, C, Selma-Ferrer, MJ, Garcia-Ortega, A, de Unamuno, B, Almendros, I, Farre, R and Gozal, D
Publicada:
1 dic 2018
Resumen:
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.
Filiaciones:
Martinez-Garcia, MA:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia, Spain
Campos-Rodriguez, F:
Hosp Valme, Resp Dept, Seville, Spain
Nagore, E:
Inst Valenciano Oncol, Dermatol Dept, Valencia, Spain
Martorell, A:
Hosp Manises, Dermatol Dept, Valencia, Spain
Rodriguez-Peralto, JL:
Hosp Univ 12 Octubre, Anat Pathol Dept, Madrid, Spain
Riveiro-Falkenbach, E:
Hosp Univ 12 Octubre, Anat Pathol Dept, Madrid, Spain
Hernandez, L:
Hosp Gen Univ Alicante, Resp Dept, Alicante, Spain
Banuls, J:
Hosp Gen Univ Alicante, Dermatol Dept, Alicante, Spain
Arias, E:
Hosp Univ 12 Octubre, Resp Dept, Madrid, Spain
Ortiz, P:
Hosp Univ 12 Octubre, Dermatol Dept, Madrid, Spain
Cabriada, V:
Hosp Univ Cruces Bilbao, Resp Dept, Bilbao, Spain
Gardeazabal, J:
Hosp Univ Cruces Bilbao, Dermatol Dept, Bilbao, Spain
Montserrat, JM:
Hosp Clin IDIBAPS, Resp Dept, Barcelona, Spain
CIBER Enfermedades Resp, CIBERes, Madrid, Spain
Carrera, C:
Hosp Clin IDIBAPS, Dermatol Dept, Barcelona, Spain
Corral, J:
Hosp Univ San Pedro de Alcantara, Resp Dept, Caceres, Spain
CIBER Enfermedades Resp, CIBERes, Madrid, Spain
Masa, JF:
Hosp Univ San Pedro de Alcantara, Resp Dept, Caceres, Spain
de Terreros, JG:
Hosp Univ San Pedro de Alcantara, Resp Dept, Caceres, Spain
CIBER Enfermedades Resp, CIBERes, Madrid, Spain
:
Hosp Univ Germans Trials I Pujol, Resp Dept, Barcelona, Spain
:
Hosp Univ Germans Trials I Pujol, Dermatol Dept, Barcelona, Spain
Mediano, O:
Hosp Univ Gen Guadalajara, Resp Dept, Guadalajara, Spain
CIBER Enfermedades Resp, CIBERes, Madrid, Spain
de Eusebio, E:
Hosp Univ Gen Guadalajara, Dermatol Dept, Guadalajara, Spain
Chiner, E:
Hosp Univ San Juan de Alicante, Resp Dept, Alicante, Spain
Landete, P:
Hosp Univ San Juan de Alicante, Resp Dept, Alicante, Spain
Mayos, M:
Hosp Univ Santa Creu & St Pau, Resp Dept, Barcelona, Spain
CIBER Enfermedades Resp, CIBERes, Madrid, Spain
Fortuna, A:
Hosp Univ Santa Creu & St Pau, Resp Dept, Barcelona, Spain
CIBER Enfermedades Resp, CIBERes, Madrid, Spain
Barbe, F:
IRBLleida, Resp Dept, Lleida, Spain
CIBER Enfermedades Resp, CIBERes, Madrid, Spain
de la Torre, MS:
IRBLleida, Resp Dept, Lleida, Spain
CIBER Enfermedades Resp, CIBERes, Madrid, Spain
de la Torre, AS:
IRBLleida, Resp Dept, Lleida, Spain
CIBER Enfermedades Resp, CIBERes, Madrid, Spain
Cano, I:
Hosp Univ Getafe, Resp Dept, Madrid, Spain
Gonzalez, C:
Hosp Univ Getafe, Dermatol Dept, Madrid, Spain
Perez-Gil, A:
Hosp Valme, Dermatol Dept, Seville, Spain
Gomez-Garcia, T:
Fdn Jimenez Diaz, Resp Dept, Madrid, Spain
CIBER Enfermedades Resp, CIBERes, Madrid, Spain
Cullen, D:
Fdn Jimenez Diaz, Dermatol Dept, Madrid, Spain
Somoza, M:
Consorcio Sanitario Terrassa, Resp Dept, Barcelona, Spain
Formigon, M:
Consorcio Sanitario Terrassa, Dermatol Dept, Barcelona, Spain
Aizpuru, F:
Univ Basque Country, OSI Araba Univ Hosp, Basque Hlth Serv, Biostat Serv,Hlth Res Inst,Bioaraba, Bilbao, Spain
Navarro, C:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia, Spain
Selma-Ferrer, MJ:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia, Spain
Garcia-Ortega, A:
Hosp Univ & Politecn La Fe, Resp Dept, Valencia, Spain
de Unamuno, B:
Hosp Univ & Politecn la Fe, Dermatol Dept, Valencia, Spain
Almendros, I:
Univ Barcelona, Fac Med & Ciencies Salut, Unitat Biofis & Bioengn, Barcelona, Spain
CIBER Enfermedades Resp, CIBERes, Madrid, Spain
Farre, R:
Univ Barcelona, Fac Med & Ciencies Salut, Unitat Biofis & Bioengn, Barcelona, Spain
CIBER Enfermedades Resp, CIBERes, Madrid, Spain
Gozal, D:
Univ Chicago, Dept Pediat, Chicago, IL 60637 USA
Ctr Invest Biomed Red Enfermedades Resp, Madrid, Spain.
Inst Invest Biomed August Pi i Sunyer, Barcelona, Spain.
Green Accepted
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