Prognostic factors and treatment outcomes in 444 patients with mucosal melanoma

被引：79

作者：

Heppt, Markus V. ^{[1
]}

Roesch, Alexander ^{[2
,3
]}

Weide, Benjamin ^{[4
]}

Gutzmer, Ralf ^{[5
]}

Meier, Friedegund ^{[6
,7
]}

Loquai, Carmen ^{[8
]}

Kaehler, Katharina C. ^{[9
]}

Gesierich, Anja ^{[10
]}

Meissner, Markus ^{[11
]}

von Bubnoff, Dagmar ^{[12
]}

Goeppner, Daniela ^{[13
]}

Schlaak, Max ^{[14
]}

Pfoehler, Claudia ^{[15
]}

Utikal, Jochen ^{[16
,17
]}

Heinzerling, Lucie ^{[18
]}

Cosgarea, Ioana ^{[2
,3
]}

Engel, Jutta ^{[19
]}

Eckel, Renate ^{[19
]}

Martens, Alexander ^{[4
]}

Mirlach, Laura ^{[1
]}

Satzger, Imke ^{[5
]}

Schubert-Fritschle, Gabriele ^{[19
]}

Tietze, Julia K. ^{[1
]}

Berking, Carola ^{[1
]}

机构：

[1] Munich Univ Hosp LMU, Dept Dermatol & Allergy, Frauenlobstr 9-11, D-80337 Munich, Germany

[2] Univ Hosp Essen, Dept Dermatol, Hufelandstr 55, D-45122 Essen, Germany

[3] German Canc Consortium DKTK, Heidelberg, Germany

[4] Univ Hosp Tubingen, Ctr Dermatooncol, Dept Dermatol, Liebermeisterstr 25, D-72076 Tubingen, Germany

[5] Hannover Med Sch, Skin Canc Ctr Hannover HTZH, Dept Dermatol & Allergy, Carl Neuberg Str 1, D-30625 Hannover, Germany

[6] Tech Univ Dresden, Fac Med, Natl Ctr Tumor Dis, Dept Dermatol,Skin Canc Ctr, Fetscherstr 74, D-01307 Dresden, Germany

[7] Tech Univ Dresden, Univ Hosp Carl Gustav Carus, Fetscherstr 74, D-01307 Dresden, Germany

[8] Univ Med Ctr Mainz, Dept Dermatol, Langenbeckstr 1, D-55131 Mainz, Germany

[9] Univ Hosp Schleswig Holstein, Dept Dermatol, Campus Kiel,Rosalind Franklin Str 7, D-24105 Kiel, Germany

[10] Univ Hosp Wurzburg, Dept Dermatol, Josef Schneider Str 2, D-97080 Wurzburg, Germany

[11] Goethe Univ, Dept Dermatol Venereol & Allergol, Theodor Stern Kai 7, D-60590 Frankfurt, Germany

[12] Univ Freiburg, Med Ctr, Dept Dermatol, Hauptstr 7, D-79104 Freiburg, Germany

[13] Justus Liebig Univ, Univ Med Ctr Giessen & Marburg, Dept Dermatol & Allergol, Gaffkystr 14, D-35392 Giessen, Germany

[14] Univ Hosp Cologne, Ctr Integrated Oncol CIO Koln Bonn, Skin Canc Ctr, Dept Dermatol & Venereol, Kerpener Str 62, D-50937 Cologne, Germany

[15] Saarland Univ, Sch Med, Dept Dermatol, Kirrberger Str 100, D-66421 Homburg, Saar, Germany

[16] German Canc Res Ctr, Skin Canc Unit, Theodor Kutzer Ufer 1-3, D-68167 Mannheim, Germany

[17] Ruprecht Karl Univ Heidelberg, Univ Med Ctr Mannheim, Dept Dermatol Venereol & Allergol, Theodor Kutzer Ufer 1-3, D-68167 Mannheim, Germany

[18] Friedrich Alexander Univ Erlangen Nurnberg FAU, Univ Hosp Erlangen, Dept Dermatol, Ulmenweg 18, D-91054 Erlangen, Germany

[19] Ludwig Maximilian Univ LMU, Univ Hosp Munich, Dept Med Informat Proc Biometry & Epidemiol IBE, Munich Canc Registry MCR,Munich Tumor Ctr TZM, Marchioninistr 15, D-81337 Munich, Germany

来源：

EUROPEAN JOURNAL OF CANCER | 2017年 / 81卷

关键词：

Mucosal melanoma; Prognosis; Immune checkpoint blockade; Targeted therapy; KIT; Staging; Survival; RETROSPECTIVE ANALYSIS; MALIGNANT-MELANOMA; KIT EXPRESSION; CANCER CENTER; SINONASAL; HEAD; NECK; MUTATIONS; EFFICACY; IMATINIB;

D O I：

10.1016/j.ejca.2017.05.014

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Mucosal melanoma (MM) is a rare but diverse cancer entity. Prognostic factors are not well established for Caucasians with MM. Patients and methods: We analysed the disease course of 444 patients from 15 German skin cancer centres. Disease progression was determined with the cumulative incidence function. Survival times were estimated with the Kaplan-Meier method. Prognostic parameters were identified with multivariate Cox regression analysis. Results: Common anatomic sites of primary tumours were head and neck (MMHN, 37.2%), female genital tract (MMFG, 30.4%) and anorectal region (MMAN, 21.8%). MMAN patients showed the highest vertical tumour thickness (p = 0.001), had a more advanced nodal status (p = 0.014) and a higher percentage of metastatic disease (p = 0.001) at diagnosis. Mutations of NRAS (13.8%), KIT (8.6%) and BRAF (6.4%) were evenly distributed across all tumour site groups. Local relapses were observed in 32.4% and most commonly occurred in the MMHN group (pZ0.016). Male gender (p = 0.047), advanced tumour stage (p = 0.001), nodal disease (p = 0.001) and incomplete resection status (p = 0.001) were independent risk factors for disease progression. Overall survival (OS) was highest in the MMFG group (p = 0.030) and in patients without ulceration (p = 0.004). Multivariate risk factors for OS were M stage at diagnosis (p = 0.002) and incomplete resection of the primary tumour (p = 0.001). Conclusion: In this large series of MM patients in a European population, anorectal MM was associated with the poorest prognosis. (C) 2017 Elsevier Ltd. All rights reserved.

引用

页码：36 / 44

页数：9

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