Clinical outcome of patients with metastatic melanoma of unknown primary in the era of novel therapy

Verver, Daniëlle; Grünhagen, Dirk J.; Akkooi, A.C.J. van; Aarts, Maureen J.B.; Berkmortel, Franchette W P J van den; Eertwegh, A.J.M. van den; Groot, Jan Willem B. de; Boers‐Sonderen, Marye J.; Haanen, John B.A.G.; Hospers, Geke A.P.; Piersma, Djura; Rijn, Rozemarijn S. van; Suijkerbuijk, Karijn P M; Tije, Albert J. ten; Vreugdenhil, Gerard; Verhoef, Cornelis; Veldt, Astrid A.M. van der

doi:10.1007/s00262-021-02871-1

Cited by 8 publications

(2 citation statements)

References 49 publications

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“…These often present with lymph node metastases only, so they do not fit within our definition of M1 disease (distant metastases). Still, we included them in our analyses because they share similar treatment strategies ( 12 ).…”

Section: Methodsmentioning

confidence: 99%

Changes in survival in de novo metastatic cancer in an era of new medicines

Luyendijk

Visser

Blommestein

et al. 2023

JNCI: Journal of the National Cancer Institute

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Background Over the past decades, the therapeutic landscape has markedly changed for patients with metastatic solid cancer, yet few studies have evaluated its effect on population-based survival. The objective of this study was to evaluate the change in survival of patients with de novo metastatic solid cancers during the last 30 years. Methods For this retrospective study, data from almost 2 million patients diagnosed with a solid cancer between January 1, 1989, and December 31, 2018, were obtained from the Netherlands Cancer Registry, with follow-up until January 31, 2021. We classified patients as with or without de novo metastatic disease (M1 or M0, respectively) at diagnosis and determined the proportion with M1 disease over time. Changes in age-standardized net survival were calculated as the difference in the 1- and 5-year survival rates of patients diagnosed in 1989-1993 and 2014-2018. Results Different cancers showed divergent trends in the proportion of M1 disease and increases in net survival for M1 disease (approximately 0-50 percentage points at both 1 and 5 years). Patients with gastrointestinal stromal tumors saw the largest increases in 5-year survival, but we also observed substantial 5-year survival increases for patients with neuroendocrine tumors, melanoma, prostate cancer, and breast cancer. Conclusion Over 30 years, the survival of patients with de novo M1 disease modestly and unevenly increased among cancers. Metastatic cancer still remains a very lethal disease. Next to better treatment options, we call for better preventive measures and early detection to reduce the incidence of metastatic disease.

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Section: Methodsmentioning

confidence: 99%

Changes in survival in de novo metastatic cancer in an era of new medicines

Luyendijk

Visser

Blommestein

et al. 2023

JNCI: Journal of the National Cancer Institute

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“…[17,18] P. Lodding [19] reported 7 cases that resembled MPNST or monophasic synovial sarcoma. And Danielle Verver [20] noted that patients with Melanoma of unknown primary typically exhibit poorer prognostic characteristics than those with melanoma of known primary. Accurate diagnosis is essential for clinical doctors to provide appropriate treatment and improve the prognosis and quality of life for patients.…”

Section: Discussionmentioning

confidence: 99%

Neurosarcomatous amelanotic transformation of malignant melanoma presenting as malignant periopheral nerve sheath tumor: Rare case report

Bofan,

Xiaofei,

Jingwen

et al. 2023

Medicine

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Rationale: Malignant melanoma (MM) is notorious for its remarkable morphological variation and aberrant histopathological patterns. In addition, Malignant Periopheral Nerve Sheath Tumor (MPNST) is an uncommon but aggressive soft tissue sarcoma. Because of the common embryological origin of melanocytes and Schwann cells in the neural crest, discriminating between a particular type of MM and MPNST can be difficult, particularly when they are amelanotic. Our goal is to increase awareness among clinicians of the rare variations of MM and the importance of medical history in improving the accuracy of the final clinical diagnosis. Patient concerns: A 68-year-old man was admitted to the hospital due to pain in his right ankle, which had persisted for 8 months, along with swelling for 4 months. Medical history revealed delayed healing of right plantar for 5 years after a traumatic injury. Diagnoses: The ankle mass was initially diagnosed as MPNST through biopsy. After reviewing the patient’s medical history and receiving the final pathological report following amputation, we have revised the diagnosis to metastatic amelanotic desmoplastic melanoma in the ankle part and lentigo maligna melanoma in the plantar part. This is due to both lesions displaying positive markers or mutated genes in immunohistology and Gene Mutation Detection, indicating homology between the 2 tumors. Interventions: Due to the malignant characteristics of the tumor and the patient’s wishes, amputation of the right lower leg was carried out. Outcomes: Subsequently, the patient was treated with interferon-γ and immunosuppressant PD-1 inhibitor, and survived for 1 year after amputation. Lessons: Clinical data, immunohistochemisty biomarkers and genes detection results can serve as valuable evidence for pathologists and clinicians in identifying the disease process. Collaborative efforts between clinicians and scientists are crucial in order to identify specific markers that can effectively differentiate between the 2 tumors, thereby enhancing the conclusiveness of the diagnosis.

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Brain metastases in adult patients with melanoma of unknown primary in the Netherlands (2011–2020)

Padilla

Mooijenkind

et al. 2023

J Neurooncol

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BackgroundAlthough patients with melanoma of unknown primary (MUP) have a better prognosis than similar-staged melanoma patients with known primary, the occurrence of brain metastases (BM) entails a serious complication. This study provides an overview of the incidence, treatment patterns, and overall survival (OS) of adult patients with BM-MUP in the Netherlands. MethodsBM-MUP cases were retrieved from the Netherlands Cancer Registry. Patient, disease and treatmentrelated characteristics were summarised using descriptive statistics. Overall survival (OS) was calculated by the Kaplan-Meier method, and the impact of prognostic factors on OS was assessed using Cox proportional hazard regression analyses. ResultsAmong 1,779 MUP patients, 450 were identi ed as BM-MUP (25.3%). Of these patients, 381 (84.7%) presented with BM along with other metastases, while 69 (15.3%) had BM only. BM-MUP patients were predominantly male (68.2%), and had a median age of 64 years at diagnosis (interquartile range 54-71 years). Over time, the proportion of BM along other metastatic sites increased, and the occurrence of BM decreased (p = 0.01). 1-Year OS improved for the total population, from 30.0% (95% con dence interval (CI): 19.8-40.9%) in 2011-2012 to 43.6% (95%CI: 34.5-52.3%) in 2019-2020, and median OS more than doubled from 4.2 months (95%CI: 3.3-6.2 months) to 9.8 months (95%CI: 7.0-13.2 months). Patient's age, localisation of BM, presence of synchronous liver metastasis and treatment were identi ed as independent predictors of OS. ConclusionNotwithstanding the progress made in OS for patients with BM-MUP in the past decade, their overall prognosis remains poor, and further efforts are needed to improve outcomes.

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Clinical outcome of patients with metastatic melanoma of unknown primary in the era of novel therapy

Cited by 8 publications

References 49 publications

Changes in survival in de novo metastatic cancer in an era of new medicines

Changes in survival in de novo metastatic cancer in an era of new medicines

Neurosarcomatous amelanotic transformation of malignant melanoma presenting as malignant periopheral nerve sheath tumor: Rare case report

Brain metastases in adult patients with melanoma of unknown primary in the Netherlands (2011–2020)

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