Impact of American Joint Committee on Cancer 8th edition classification on staging and survival of patients with melanoma

Kanaki, Theodora; Stang, Andreas; Gutzmer, Ralf; Zimmer, Lisa; Chorti, Eleftheria; Sucker, Antje; Ugurel, Selma; Hadaschik, Eva; Gräger, Nikolai; Satzger, Imke; Schadendorf, Dirk; Livingstone, Elisabeth

doi:10.1016/j.ejca.2019.06.011

Cited by 50 publications

(45 citation statements)

References 25 publications

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“…According to the latest global cancer statistics, more than 60 000 people died from melanoma in 2018 1 . While diagnosis of early stage melanoma has been shown to reduce mortality rates to about 20%, the prognosis of advanced stage melanoma is poor with a 5‐year survival of only about 30% 2,3 …”

Section: Introductionmentioning

confidence: 99%

The predictive and prognostic significance of cell‐free DNA concentration in melanoma

Váraljai

Elouali

Lueong

et al. 2020

Acad Dermatol Venereol

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Background Melanoma is the leading cause of skin cancer‐related deaths worldwide. While there have been significant improvements in the treatment of advanced melanoma in the past decade, biomarker development lagged behind. Objectives The majority of liquid biopsy biomarkers rely on the analyses of oncogenic mutations; however, about 20% of melanoma patients are wild type. Therefore, validation of universal predictive and prognostic biomarkers is urgently needed. Methods We analysed plasma samples in a discovery cohort (n = 20) and expansion cohort (n = 166) of metastatic melanoma patients and healthy donors (n = 116). Total plasma circulating cell‐free DNA (cfDNA) concentrations were measured on the Qubit® platform using assays for single‐(ss) and double (ds)‐stranded DNA, DNA spectrophotometry and RNase P qPCR. We explored the diagnostic, predictive and prognostic potential of cfDNA concentration by bio‐statistical methods and established a cfDNA threshold for risk stratification. Results Our selected best method was Qubit® dsDNA assay which quantified higher plasma cfDNA concentrations in melanoma patients than in healthy controls (AUC 72%). Measurement of baseline cfDNA concentration revealed that high cfDNA was associated with presence of metastases and higher AJCC stage (P < 0.05). Furthermore, high baseline cfDNA was an indicator of shorter overall survival in patients with oncogenic mutations (HR 2.12, P = 0.0008), and in wild‐type patients (HR 5.55, P < 0.0001). Conclusions We provide evidence that total cfDNA can be used as a biomarker for melanoma irrespective of the tumour genotype and can provide information on tumour load, risk of progression and risk of death.

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Section: Introductionmentioning

confidence: 99%

The predictive and prognostic significance of cell‐free DNA concentration in melanoma

Váraljai

Elouali

Lueong

et al. 2020

Acad Dermatol Venereol

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“…Skin melanoma staging was adjusted mainly in stage III, with the addition of another subgroup to further differentiate among patients with regard to survival. The application of the 8th edition of the staging system led to a the 5-year tumor-specific survival rate ranging from 93% (stage IIIA) to 32% (stage IIID), showing better discrimination than the 7th edition of the staging system, which ranged from only 78% (stage IIIA) to 40% (stage IIIC) (12). Although the difference in survival between subgroups is very obvious in the 8th edition of the staging system, we observed a very interesting phenomenon.…”

Section: Discussionmentioning

confidence: 98%

Skin melanoma survival is not superior in females in the new stage IIID of the 8th edition of the staging system: an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) database

Chen

et al. 2020

Ann Transl Med

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Background: In the 8th edition of the melanoma staging system, stage III was divided into stages IIIA-IIID. Previous studies have found that the long-term survival rate of females is much higher than that of males. This study was designed to explore whether this sex-specific advantage still exists in the new staging subgroups.Methods: We obtained data from individuals diagnosed with skin melanoma between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. A total of 8,726 patients with stage III disease were enrolled in the study (5,370 males and 3,356 females). Among these patients, 505 had stage IIID disease (370 males and 135 females).Results: In the 7th edition of the staging system, there were significant sex-specific differences in overall survival (OS) and melanoma-specific survival (MSS) in each subgroup of stage III. In stages IIIA-IIIC in the 8th edition, there were also significant differences between males and females (P<0.001), but in stage IIID patients, there were no significant differences in either OS (P=0.312) or MSS (P=0.288). Cox analysis confirmed that stage IIID does not affect prognosis in males. Further research found no difference between males and females with stage IIID disease in any age subgroup. Conclusions:We compared sex-specific survival differences in patients with stage III disease according to the 8th edition of the staging system. Females with stage IIIA-IIIC disease have better survival rates than males. However, among patients with stage IIID disease, there is no significant difference in survival between males and females.

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“…This verifies the relevance of sex hormones. Some studies have suggested that oestrogen increases the number of melanocytes and regulates melanin concentration (13). Some genetic studies have also found that mutations in the melanocortin receptor (MC1R) regulate and improve survival in females.…”

Section: Discussionmentioning

confidence: 99%

Sex-specific survival benefit in early skin melanoma based on 8th AJCC edition: an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) database

Mo¹,

Chen²,

Jiang³

et al. 2021

Ann Transl Med

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Background: Females have been found to have a survival benefit over males in past studies. However, in early melanoma patients, this benefit occurred in only those aged >60 years. The 8th edition of the American Joint Committee on Cancer (AJCC) readjusted the melanoma staging system, specifically stage I. This study aims to verify whether the sex-specific benefit in females exists in different age groups according to the 8th edition of the staging system. Methods:We collected the data of individuals diagnosed with skin melanoma between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database. Based on the 8th edition of the melanoma staging system, patients diagnosed with pathological stage T1a-T3a, N0 and M0 melanoma were enrolled.Results: A total of 115,576 patients, including 62,938 male patients and 52,638 female patients, were enrolled in this study. The survival rates of males and females in each stage from IA-IIA were significantly different (P<0.001). In further analyses of each age group, it was found that the proportions of patients with stages IA, IB and IIA were significantly different in each age group. Cox analysis showed that females with stage IA in all age groups benefited significantly, but those in stage IB benefited only when they were aged >60 years. In stage IIA patients, there were significant differences between the <50 and 61-70 years age groups.Conclusions: Based on data from the SEER database, we found that according to the 8th edition of the AJCC melanoma staging system, females had a higher survival rate than males, and this difference was significant in all age groups in the stage IA group but fluctuated with age in the stage IB and IIA groups.

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Impact of American Joint Committee on Cancer 8th edition classification on staging and survival of patients with melanoma

Cited by 50 publications

References 25 publications

The predictive and prognostic significance of cell‐free DNA concentration in melanoma

The predictive and prognostic significance of cell‐free DNA concentration in melanoma

Skin melanoma survival is not superior in females in the new stage IIID of the 8th edition of the staging system: an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) database

Sex-specific survival benefit in early skin melanoma based on 8th AJCC edition: an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) database

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