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Sleep-Disordered Breathing Is Independently Associated With Increased Aggressiveness of Cutaneous Melanoma

2018; Elsevier BV; Volume: 154; Issue: 6 Linguagem: Inglês

10.1016/j.chest.2018.07.015

1931-3543

Miguel Ángel Martínez‐García, Francisco Campos‐Rodríguez, Eduardo Nagore, A. Martorell, José Luis Rodríguez‐­Peralto, Erica Riveiro‐Falkenbach, Luís Hernández, José Bañuls, Eva Arias, Pablo L. Ortiz‐Romero, Valentín Cabriada, Jose Gardeazabal, Josep M. Montserrat, Cristina Carrera, Jaime Corral, Juan F. Masa, Javier Gómez de Terreros, Jorge Abad, Aram Boada, Olga Mediano, Esther de Eusebio, Eusebi Chiner, Pedro Landete, Mercedes Mayos, Ana Fortuño, Ferrán Barbé, Manuel Sánchez‐de‐la‐Torre, Manuel Sánchez‐de‐la‐Torre, Irene Cano‐Pumarega, Cristina González, Amalia Pérez‐Gil, Teresa Gómez‐García, D. Cullen, María Salgado Somoza, Manuel Formigón, Felipe Aizpuru, Cristina Navarro‐Soriano, Maria Jose Selma-Ferrer, Alberto García‐Ortega, Blanca de Unamuno, Isaac Almendros, Ramón Farré, David Gozal, Isabel Betlloch, M. Moragón, Esther Pastor, Verónica Velasco, Amaia Urrutia, Cristian Perna, Zully Adjani Vasquez, José Antonio Aramburu, Aída Selfa Muñoz, M. Angeles Gonzalez, Joan Dalmau, Manuel Martín González, Anna Mozos, Erika Miranda, Maider Mateos, Paula Rodríguez, María F. Troncoso, Mónica de la Peña, L.J. del Pozo, Mónica González, P Manchado, Santiago Juarros, J. Garcia Caballero, Eduardo Alcaraz, Andrea Crespo, J. Víctor Marcos, Lorena Comeche, Martina Alés, Mónica Llombart, M. Pérez‐Crespo, Bienvenido Barreiro, N. Curcó, Olga Cantalejo, Nuria Reyes-Núñez, Antonio Cruz-Medina, Raquel Poquet Catalá, A Azón, Núria Grau, Sònia Segura,

Sleep and Wakefulness Research

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. 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. 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. 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. The severity of SDB was independently associated with greater aggressiveness of cutaneous melanoma, particularly among younger patients.