Obstructive Sleep Apnea Syndrome Clinical Trial
Official title:
Impact of Obstructive Sleep Apnea Syndrome on Metastatic Potential of Cutaneous Melanoma : Prospective Study in Patients With High Risk Melanoma
Hypothesis: to address if diagnosis of obstructive sleep apnea before or during the
extending check-up is a risk factor toward metastasis for melanoma stage ≥ tIIaN0M0 Study
design: Adult patients with a Breslow's Thickness ≥ 1mm coming to the surgery consultation
will have a nocturnal oximetry for screening of obstructive sleep apnea. Patients having an
abnormal nocturnal oximetry will be explored by polysomnography in order to detect sleep
apnea syndrome. Patients with sleep apnea will be treated.
Standard dermatologic follow-up over a 3 years period with thoraco-abdominal-pelvic and
cerebral CT-scan and a lymph-node ultrasound every 6 months will be performed.
Melanoma is a cutaneous cancer due to a proliferation of melanocytes. For metastatic cases
the prognostic is poor (18% survival at 5 years). Few factors predict metastasis. Sleep
Apnea Syndrome is involved in mechanism of carcinogenesis and aggressiveness markers of
malignant cutaneous melanoma.
Hypothesis: to address if diagnosis of obstructive sleep apnea before or during the
extending check-up is a risk factor toward metastasis for melanoma stage ≥ tIIaN0M0 Study
design: Adult patients with a Breslow's Thickness ≥ 1mm coming to the surgery consultation
will have a nocturnal oximetry for screening of obstructive sleep apnea. Patients having an
abnormal nocturnal oximetry will be explored by polysomnography in order to detect sleep
apnea syndrome. Patients with sleep apnea will be treated.
Standard dermatologic follow-up over a 3 years period with thoraco-abdominal-pelvic and
cerebral CT-scan and a lymph-node ultrasound every 6 months will be performed.
Sample size: based on previous data from the investigators showing that 25% of patients with
a Breslow's Thickness ≥ 1mm will have node or visceral metastasis. For an alpha threshold of
5% and a study power of 80%, with 5% of dropouts, with the hypothesis that 40% of apnea
syndrome patients will metastasis versus 20% in the control group the study should include
83 patients in each group.
Statistical analysis: an intermediate analysis after 80 included patients will be performed.
Peto method will be followed, results will be considered significant with a p≤0.001 and the
study will be stopped.
Normality of data will be checked by Kurtosis and Skewness tests, variance equality will be
tested with the Leven test. The significance level will be set at 5%.
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