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Erschienen in: Tumor Biology 8/2016

04.02.2016 | Original Article

Clinical characteristics and prognostic indicators for metastatic melanoma: data from 446 patients in north China

verfasst von: Mengze Hao, Gang Zhao, Xiaoling Du, Yun Yang, Jilong Yang

Erschienen in: Tumor Biology | Ausgabe 8/2016

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Abstract

Melanoma is an extremely rare tumor in Asia. This retrospective study aimed to identify the clinical characteristics and prognostic factors of metastatic melanoma patients at Tianjin Medical University Cancer Hospital over the last 30 years. Survival analysis was performed with Kaplan-Meier, log-rank test, and multivariate Cox regression method using SPSS 19.0 software. The 1-, 2-, and 5-year survival rates of metastatic melanoma patients were 52, 32, and 16 %, respectively. Median overall survival (OS) was 13.5 months, median progression-free survival (PFS) 9.0 months, and median disease-free survival 20.3 months. Furthermore, patients with a single metastatic site achieved better OS and PFS than those with two or more metastatic lesions (OS 21.6 vs. 8.9 months, P < 0.001; PFS 11.3 vs. 7.1 months, P < 0.001). Survival times of patients with visceral metastases were the shortest (OS 8.5 months; PFS 7.5 months). Specifically, patients with primary mucosal lesions had a worse OS (9.7 months) and PFS (6.8 months) than those with acral (19.2 and 15.6 months, respectively) or non-acral primary lesions (11.8 and 11.1 months, respectively). The treatment of advanced melanoma was unitary, and prognoses of patients with metastatic melanoma in China were poor. Visceral metastasis, multiple metastatic sites, and primary mucosal lesions were significant predictors of survival of patients with metastatic melanoma. Those with primary mucosal lesions had significantly worse survivals than those with primary cutaneous lesions. More active involvement in clinical studies and more feedback on various treatment options are required.
Literatur
1.
Zurück zum Zitat Kosary CL, Altekruse SF, Ruhl J, Lee R, Dickie L. Clinical and prognostic factors for melanoma of the skin using seer registries: collaborative stage data collection system, version 1 and version 2. Cancer. 2014;120 Suppl 23:3807–14.CrossRefPubMed Kosary CL, Altekruse SF, Ruhl J, Lee R, Dickie L. Clinical and prognostic factors for melanoma of the skin using seer registries: collaborative stage data collection system, version 1 and version 2. Cancer. 2014;120 Suppl 23:3807–14.CrossRefPubMed
2.
Zurück zum Zitat Korta DZ, Saggar V, Wu TP, Sanchez M. Racial differences in skin cancer awareness and surveillance practices at a public hospital dermatology clinic. J Am Acad Dermatol. 2014;70:312–7.CrossRefPubMed Korta DZ, Saggar V, Wu TP, Sanchez M. Racial differences in skin cancer awareness and surveillance practices at a public hospital dermatology clinic. J Am Acad Dermatol. 2014;70:312–7.CrossRefPubMed
3.
4.
Zurück zum Zitat Coit DG, Thompson JA, Andtbacka R, Anker CJ, Bichakjian CK, Carson 3rd WE, et al. Melanoma, version 4. 2014. J Natl Compr Canc Netw. 2014;12:621–9.PubMed Coit DG, Thompson JA, Andtbacka R, Anker CJ, Bichakjian CK, Carson 3rd WE, et al. Melanoma, version 4. 2014. J Natl Compr Canc Netw. 2014;12:621–9.PubMed
5.
Zurück zum Zitat Rastrelli M, Tropea S, Rossi CR, Alaibac M. Melanoma: epidemiology, risk factors, pathogenesis, diagnosis and classification. In Vivo. 2014;28:1005–11.PubMed Rastrelli M, Tropea S, Rossi CR, Alaibac M. Melanoma: epidemiology, risk factors, pathogenesis, diagnosis and classification. In Vivo. 2014;28:1005–11.PubMed
7.
Zurück zum Zitat Zhu H, Dong D, Li F, Liu D, Wang L, Fu J, et al. Clinicopathologic features and prognostic factors in patients with non-cutaneous malignant melanoma: s single-center retrospective study of 71 cases. Int J Dermatol. 2015;54(12):1390–5.CrossRefPubMed Zhu H, Dong D, Li F, Liu D, Wang L, Fu J, et al. Clinicopathologic features and prognostic factors in patients with non-cutaneous malignant melanoma: s single-center retrospective study of 71 cases. Int J Dermatol. 2015;54(12):1390–5.CrossRefPubMed
8.
Zurück zum Zitat Song X, Zhao Z, Barber B, Farr AM, Ivanov B, Novich M. Overall survival in patients with metastatic melanoma. Curr Med Res Opin. 2015;31(5):987–91. Song X, Zhao Z, Barber B, Farr AM, Ivanov B, Novich M. Overall survival in patients with metastatic melanoma. Curr Med Res Opin. 2015;31(5):987–91.
9.
Zurück zum Zitat Zhong J, Zhou JN, Xu FP, Shang JQ. Diagnosis and treatment of anorectal malignant melanoma—a report of 22 cases with literature review. Chin J Cancer. 2006;25:619–24. Zhong J, Zhou JN, Xu FP, Shang JQ. Diagnosis and treatment of anorectal malignant melanoma—a report of 22 cases with literature review. Chin J Cancer. 2006;25:619–24.
10.
Zurück zum Zitat Debarbieux S, Duru G, Dalle S, Beatrix O, Balme B, Thomas L. Sentinel lymph node biopsy in melanoma: a micromorphometric study relating to prognosis and completion lymph node dissection. Br J Dermatol. 2007;157:58–67.CrossRefPubMed Debarbieux S, Duru G, Dalle S, Beatrix O, Balme B, Thomas L. Sentinel lymph node biopsy in melanoma: a micromorphometric study relating to prognosis and completion lymph node dissection. Br J Dermatol. 2007;157:58–67.CrossRefPubMed
11.
Zurück zum Zitat Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR, et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol. 2009;27:6199–206.CrossRefPubMedPubMedCentral Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR, et al. Final version of 2009 AJCC melanoma staging and classification. J Clin Oncol. 2009;27:6199–206.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Bostanci O, Kartal K. Liver metastases of unknown primary. Malignant Melanoma. 2014;2014:131708. Bostanci O, Kartal K. Liver metastases of unknown primary. Malignant Melanoma. 2014;2014:131708.
13.
Zurück zum Zitat Erez A, Shental O, Tchebiner JZ, Laufer-Perl M, Wasserman A, Sella T, et al. Diagnostic and prognostic value of very high serum lactate dehydrogenase in admitted medical patients. Isr Med Assoc J. 2014;16:439–43.PubMed Erez A, Shental O, Tchebiner JZ, Laufer-Perl M, Wasserman A, Sella T, et al. Diagnostic and prognostic value of very high serum lactate dehydrogenase in admitted medical patients. Isr Med Assoc J. 2014;16:439–43.PubMed
15.
Zurück zum Zitat Moreno-Ramirez D, Ojeda-Vila T, Rios-Martin JJ, Nieto-Garcia A, Ferrandiz L. Role of age and sex in the diagnosis of early-stage malignant melanoma: a cross-sectional study. Acta Derm Venereol. 2015;95(8):940–2.CrossRefPubMed Moreno-Ramirez D, Ojeda-Vila T, Rios-Martin JJ, Nieto-Garcia A, Ferrandiz L. Role of age and sex in the diagnosis of early-stage malignant melanoma: a cross-sectional study. Acta Derm Venereol. 2015;95(8):940–2.CrossRefPubMed
16.
Zurück zum Zitat Haas A, Pinter O, Papaefthymiou G, Weger M, Berghold A, Schrottner O, et al. Incidence of radiation retinopathy after high-dosage single-fraction gamma knife radiosurgery for choroidal melanoma. Ophthalmology. 2002;109:909–13.CrossRefPubMed Haas A, Pinter O, Papaefthymiou G, Weger M, Berghold A, Schrottner O, et al. Incidence of radiation retinopathy after high-dosage single-fraction gamma knife radiosurgery for choroidal melanoma. Ophthalmology. 2002;109:909–13.CrossRefPubMed
17.
Zurück zum Zitat Philippart P, da Costa PM, Heymans O, Pector JC, de Saint-Aubin N, Andry G. Metastatic involvement of ceco-appendicular segment: a diagnosis of right lower quadrant abdominal pain in patient receiving chemotherapy. Hepato-Gastroenterol. 2000;47:1627–9. Philippart P, da Costa PM, Heymans O, Pector JC, de Saint-Aubin N, Andry G. Metastatic involvement of ceco-appendicular segment: a diagnosis of right lower quadrant abdominal pain in patient receiving chemotherapy. Hepato-Gastroenterol. 2000;47:1627–9.
18.
Zurück zum Zitat Avery-Kiejda KA, Bowden NA, Croft AJ, Scurr LL, Kairupan CF, Ashton KA, et al. P53 in human melanoma fails to regulate target genes associated with apoptosis and the cell cycle and may contribute to proliferation. BMC Cancer. 2011;11:203.CrossRefPubMedPubMedCentral Avery-Kiejda KA, Bowden NA, Croft AJ, Scurr LL, Kairupan CF, Ashton KA, et al. P53 in human melanoma fails to regulate target genes associated with apoptosis and the cell cycle and may contribute to proliferation. BMC Cancer. 2011;11:203.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Cascinelli N, Heerlyn M, Schneeberger A, Kuwert C, Slominski A, Armstrong C, et al. What is the most promising strategy for the treatment of metastasizing melanoma? Exp Dermatol. 2000;9:439–51.CrossRefPubMed Cascinelli N, Heerlyn M, Schneeberger A, Kuwert C, Slominski A, Armstrong C, et al. What is the most promising strategy for the treatment of metastasizing melanoma? Exp Dermatol. 2000;9:439–51.CrossRefPubMed
20.
Zurück zum Zitat Chen W, Zheng R, Zhang S, Zhao P, Zeng H, Zou X. The incidences and mortalities of major cancers in China, 2010. Chin J Cancer. 2014;33(8):402–5.PubMedPubMedCentral Chen W, Zheng R, Zhang S, Zhao P, Zeng H, Zou X. The incidences and mortalities of major cancers in China, 2010. Chin J Cancer. 2014;33(8):402–5.PubMedPubMedCentral
21.
Zurück zum Zitat Eggermont AM, Robert C. New drugs in melanoma: it’s a whole new world. Eur J Cancer. 2011;47:2150–7.CrossRefPubMed Eggermont AM, Robert C. New drugs in melanoma: it’s a whole new world. Eur J Cancer. 2011;47:2150–7.CrossRefPubMed
22.
Zurück zum Zitat Jang S, Atkins MB. Which drug, and when, for patients with BRAF-mutant melanoma? Lancet Oncol. 2013;14:e60–9.CrossRefPubMed Jang S, Atkins MB. Which drug, and when, for patients with BRAF-mutant melanoma? Lancet Oncol. 2013;14:e60–9.CrossRefPubMed
23.
Zurück zum Zitat Cybulska-Stopa B, Skoczek M, Ziobro M, Switaj T, Falkowski S, Morysinski T, et al. Results of systemic treatment of cutaneous melanoma in inoperable stage iii and iv. Contemp Oncol (Pozn). 2012;16:532–45. Cybulska-Stopa B, Skoczek M, Ziobro M, Switaj T, Falkowski S, Morysinski T, et al. Results of systemic treatment of cutaneous melanoma in inoperable stage iii and iv. Contemp Oncol (Pozn). 2012;16:532–45.
24.
Zurück zum Zitat Sandru A, Voinea S, Panaitescu E, Blidaru A. Survival rates of patients with metastatic malignant melanoma. J Med Life. 2014;7:572–6.PubMedPubMedCentral Sandru A, Voinea S, Panaitescu E, Blidaru A. Survival rates of patients with metastatic malignant melanoma. J Med Life. 2014;7:572–6.PubMedPubMedCentral
25.
Zurück zum Zitat Shields CL, Shields MV, Viloria V, Pearlstein H, Say EA, Shields JA. Iridocorneal endothelial syndrome masquerading as iris melanoma in 71 cases. Arch Ophthalmol. 2011;129:1023–9.CrossRefPubMed Shields CL, Shields MV, Viloria V, Pearlstein H, Say EA, Shields JA. Iridocorneal endothelial syndrome masquerading as iris melanoma in 71 cases. Arch Ophthalmol. 2011;129:1023–9.CrossRefPubMed
26.
Zurück zum Zitat Chi Z, Li S, Sheng X, Si L, Cui C, Han M, et al. Clinical presentation, histology, and prognoses of malignant melanoma in ethnic Chinese: a study of 522 consecutive cases. BMC Cancer. 2011;11:85.CrossRefPubMedPubMedCentral Chi Z, Li S, Sheng X, Si L, Cui C, Han M, et al. Clinical presentation, histology, and prognoses of malignant melanoma in ethnic Chinese: a study of 522 consecutive cases. BMC Cancer. 2011;11:85.CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Lepper W, Shivalkar B, Rinkevich D, Belcik T, Wei K. Assessment of the vascularity of a left ventricular mass using myocardial contrast echocardiography. J Am Soc Echocardiogr. 2002;15:1419–22.CrossRefPubMed Lepper W, Shivalkar B, Rinkevich D, Belcik T, Wei K. Assessment of the vascularity of a left ventricular mass using myocardial contrast echocardiography. J Am Soc Echocardiogr. 2002;15:1419–22.CrossRefPubMed
28.
Zurück zum Zitat Fujii K, Komurasaki Y, Kanno Y, Ohgou N. Unilateral exophthalmos due to orbital metastasis from a contralateral intraocular melanoma. Eur J Dermatol. 1998;8:343–6.PubMed Fujii K, Komurasaki Y, Kanno Y, Ohgou N. Unilateral exophthalmos due to orbital metastasis from a contralateral intraocular melanoma. Eur J Dermatol. 1998;8:343–6.PubMed
29.
Zurück zum Zitat Rutkowski P, Debiec-Rychter M, Ruka W. Gastrointestinal stromal tumors: key to diagnosis and choice of therapy. Mol Diagn Ther. 2008;12:131–43.CrossRefPubMed Rutkowski P, Debiec-Rychter M, Ruka W. Gastrointestinal stromal tumors: key to diagnosis and choice of therapy. Mol Diagn Ther. 2008;12:131–43.CrossRefPubMed
30.
Zurück zum Zitat Dabouz F, Barbe C, Lesage C, Le Clainche A, Arnoult G, Hibon E, et al. Clinical and histological features of head and neck melanoma: a population-based study in France. Br J Dermatol. 2014;172(3):707–15.CrossRef Dabouz F, Barbe C, Lesage C, Le Clainche A, Arnoult G, Hibon E, et al. Clinical and histological features of head and neck melanoma: a population-based study in France. Br J Dermatol. 2014;172(3):707–15.CrossRef
31.
Zurück zum Zitat Andersen PS, Chakera AH, Thamsborg AK, Kolle SF, Schmidt G, Klyver H, et al. Recurrence and survival after neck dissections in cutaneous head and neck melanoma. Dan Med J. 2014;61:A4953.PubMed Andersen PS, Chakera AH, Thamsborg AK, Kolle SF, Schmidt G, Klyver H, et al. Recurrence and survival after neck dissections in cutaneous head and neck melanoma. Dan Med J. 2014;61:A4953.PubMed
32.
Zurück zum Zitat Franzke A, Probst-Kepper M, Buer J, Duensing S, Hoffmann R, Wittke F, et al. Elevated pretreatment serum levels of soluble vascular cell adhesion molecule 1 and lactate dehydrogenase as predictors of survival in cutaneous metastatic malignant melanoma. Br J Cancer. 1998;78:40–5.CrossRefPubMedPubMedCentral Franzke A, Probst-Kepper M, Buer J, Duensing S, Hoffmann R, Wittke F, et al. Elevated pretreatment serum levels of soluble vascular cell adhesion molecule 1 and lactate dehydrogenase as predictors of survival in cutaneous metastatic malignant melanoma. Br J Cancer. 1998;78:40–5.CrossRefPubMedPubMedCentral
33.
Zurück zum Zitat Schmidt H, Bastholt L, Geertsen P, Christensen IJ, Larsen S, Gehl J, et al. Elevated neutrophil and monocyte counts in peripheral blood are associated with poor survival in patients with metastatic melanoma: a prognostic model. Br J Cancer. 2005;93:273–8.CrossRefPubMedPubMedCentral Schmidt H, Bastholt L, Geertsen P, Christensen IJ, Larsen S, Gehl J, et al. Elevated neutrophil and monocyte counts in peripheral blood are associated with poor survival in patients with metastatic melanoma: a prognostic model. Br J Cancer. 2005;93:273–8.CrossRefPubMedPubMedCentral
34.
Zurück zum Zitat Pan Y, Haydon AM, McLean CA, McDonald PB, Kelly JW. Prognosis associated with cutaneous melanoma metastases. Australas J Dermatol. 2015;56:25–8.CrossRefPubMed Pan Y, Haydon AM, McLean CA, McDonald PB, Kelly JW. Prognosis associated with cutaneous melanoma metastases. Australas J Dermatol. 2015;56:25–8.CrossRefPubMed
35.
Zurück zum Zitat Brand CU, Ellwanger U, Stroebel W, Meier F, Schlagenhauff B, Rassner G, et al. Prolonged survival of 2 years or longer for patients with disseminated melanoma. An analysis of related prognostic factors. Cancer. 1997;79:2345–53.CrossRefPubMed Brand CU, Ellwanger U, Stroebel W, Meier F, Schlagenhauff B, Rassner G, et al. Prolonged survival of 2 years or longer for patients with disseminated melanoma. An analysis of related prognostic factors. Cancer. 1997;79:2345–53.CrossRefPubMed
36.
Zurück zum Zitat Eton O, Legha SS, Moon TE, Buzaid AC, Papadopoulos NE, Plager C, et al. Prognostic factors for survival of patients treated systemically for disseminated melanoma. J Clin Oncol. 1998;16:1103–11.CrossRefPubMed Eton O, Legha SS, Moon TE, Buzaid AC, Papadopoulos NE, Plager C, et al. Prognostic factors for survival of patients treated systemically for disseminated melanoma. J Clin Oncol. 1998;16:1103–11.CrossRefPubMed
37.
Zurück zum Zitat Manola J, Atkins M, Ibrahim J, Kirkwood J. Prognostic factors in metastatic melanoma: a pooled analysis of eastern cooperative oncology group trials. J Clin Oncol. 2000;18:3782–93.CrossRefPubMed Manola J, Atkins M, Ibrahim J, Kirkwood J. Prognostic factors in metastatic melanoma: a pooled analysis of eastern cooperative oncology group trials. J Clin Oncol. 2000;18:3782–93.CrossRefPubMed
38.
Zurück zum Zitat Bartlett EK, Karakousis GC. Current staging and prognostic factors in melanoma. Surg Oncol Clin N Am. 2015;24:215–27.CrossRefPubMed Bartlett EK, Karakousis GC. Current staging and prognostic factors in melanoma. Surg Oncol Clin N Am. 2015;24:215–27.CrossRefPubMed
39.
Zurück zum Zitat Deichmann M, Benner A, Bock M, Jackel A, Uhl K, Waldmann V, et al. S100-beta, melanoma-inhibiting activity, and lactate dehydrogenase discriminate progressive from nonprogressive American Joint Committee on Cancer stage iv melanoma. J Clin Oncol. 1999;17:1891–6.CrossRefPubMed Deichmann M, Benner A, Bock M, Jackel A, Uhl K, Waldmann V, et al. S100-beta, melanoma-inhibiting activity, and lactate dehydrogenase discriminate progressive from nonprogressive American Joint Committee on Cancer stage iv melanoma. J Clin Oncol. 1999;17:1891–6.CrossRefPubMed
40.
Zurück zum Zitat Diem S, Kasenda B, Martin-Liberal J, Lee A, Chauhan D, Gore M, et al. Prognostic score for patients with advanced melanoma treated with ipilimumab. Eur J Cancer. 2015;51:2785–91.CrossRefPubMed Diem S, Kasenda B, Martin-Liberal J, Lee A, Chauhan D, Gore M, et al. Prognostic score for patients with advanced melanoma treated with ipilimumab. Eur J Cancer. 2015;51:2785–91.CrossRefPubMed
41.
Zurück zum Zitat Unger JM, Flaherty LE, Liu PY, Albain KS, Sondak VK. Gender and other survival predictors in patients with metastatic melanoma on southwest oncology group trials. Cancer. 2001;91:1148–55.CrossRefPubMed Unger JM, Flaherty LE, Liu PY, Albain KS, Sondak VK. Gender and other survival predictors in patients with metastatic melanoma on southwest oncology group trials. Cancer. 2001;91:1148–55.CrossRefPubMed
42.
Zurück zum Zitat Joosse A, Collette S, Suciu S, Nijsten T, Lejeune F, Kleeberg UR, et al. Superior outcome of women with stage i/ii cutaneous melanoma: pooled analysis of four European organisation for research and treatment of cancer phase iii trials. J Clin Oncol. 2012;30:2240–7.CrossRefPubMed Joosse A, Collette S, Suciu S, Nijsten T, Lejeune F, Kleeberg UR, et al. Superior outcome of women with stage i/ii cutaneous melanoma: pooled analysis of four European organisation for research and treatment of cancer phase iii trials. J Clin Oncol. 2012;30:2240–7.CrossRefPubMed
43.
Zurück zum Zitat Joosse A, Collette S, Suciu S, Nijsten T, Patel PM, Keilholz U, et al. Sex is an independent prognostic indicator for survival and relapse/progression-free survival in metastasized stage iii to iv melanoma: a pooled analysis of five European organisation for research and treatment of cancer randomized controlled trials. J Clin Oncol. 2013;31:2337–46.CrossRefPubMed Joosse A, Collette S, Suciu S, Nijsten T, Patel PM, Keilholz U, et al. Sex is an independent prognostic indicator for survival and relapse/progression-free survival in metastasized stage iii to iv melanoma: a pooled analysis of five European organisation for research and treatment of cancer randomized controlled trials. J Clin Oncol. 2013;31:2337–46.CrossRefPubMed
Metadaten
Titel
Clinical characteristics and prognostic indicators for metastatic melanoma: data from 446 patients in north China
verfasst von
Mengze Hao
Gang Zhao
Xiaoling Du
Yun Yang
Jilong Yang
Publikationsdatum
04.02.2016
Verlag
Springer Netherlands
Erschienen in
Tumor Biology / Ausgabe 8/2016
Print ISSN: 1010-4283
Elektronische ISSN: 1423-0380
DOI
https://doi.org/10.1007/s13277-016-4914-4

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