Supplementary Material for: Impact of Age on the Management of Primary Melanoma Patients

<b><i>Objectives:</i></b> Age is an understudied factor when considering treatment options for melanoma. Here, we examine the impact of age on primary melanoma treatment in a prospective cohort of patients. <b><i>Methods:</i></b> We used logistic regression models to examine the associations between age and initial treatment, using recurrence and melanoma-specific survival as endpoints. <b><i>Results:</i></b> 444 primary melanoma patients were categorized into three groups by age at diagnosis: 19-45 years (24.3%), 46-70 (50.2%), and 71-95 (25.5%). In multivariate models, older patients experienced a higher risk of recurrence (hazard ratio 3.34, 95% confidence interval, CI, 1.53-7.25; p &lt; 0.01). No significant differences were observed in positive biopsy margin rates or extent of surgical margins across age groups. Patients in the middle age group were more likely to receive adjuvant therapy than those in the older group (odds ratio 2.78, 95% CI 1.19-6.45; p = 0.02) and showed a trend to longer disease-free survival when receiving adjuvant therapy (p = 0.09). <b><i>Conclusion:</i></b> Our data support age as an independent negative prognostic factor in melanoma. Our data suggest that age does not affect primary surgical treatment but may affect decisions of whether or not patients receive postoperative treatment(s). Further work is needed to better understand the biological variables affecting treatment decisions and efficacy in older patients.

<b><i>研究目的：</i></b> 在考量黑色素瘤的治疗方案时，年龄是一个尚未得到充分研究的影响因素。本研究基于某前瞻性队列患者群体，探讨年龄对原发性黑色素瘤治疗的影响。
<b><i>研究方法：</i></b> 本研究采用逻辑回归（logistic regression）模型，以复发情况及黑色素瘤特异性生存作为结局指标，分析年龄与初始治疗方案之间的关联。
<b><i>研究结果：</i></b> 本研究共纳入444例原发性黑色素瘤患者，按确诊时的年龄划分为三组：19~45岁组（24.3%）、46~70岁组（50.2%）及71~95岁组（25.5%）。多因素分析结果显示，高龄患者的复发风险显著升高（风险比（hazard ratio, HR）=3.34，95%置信区间（confidence interval, CI）：1.53~7.25；p<0.01）。不同年龄组的活检切缘阳性率及手术切缘范围均未出现显著差异。中年组患者接受辅助治疗的概率显著高于老年组（比值比（odds ratio, OR）=2.78，95% CI：1.19~6.45；p=0.02），且在接受辅助治疗后，其无病生存期（disease-free survival, DFS）呈现延长趋势（p=0.09）。
<b><i>研究结论：</i></b> 本研究数据证实，年龄是黑色素瘤的独立不良预后因素。同时本研究结果表明，年龄不会对原发性手术治疗产生影响，但可能会影响患者术后是否接受辅助治疗的决策。未来仍需开展进一步研究，以更好地明确影响老年患者治疗决策及治疗疗效的生物学相关变量。