Metastatic Volume: An Old Oncologic Concept and a New Prognostic Factor for Stage IV Melanoma Patients

Abstract

Background: The last melanoma staging system of the 2009 American Joint Committee on Cancer takes into account, for stage IV disease, the serum levels of lactate dehydrogenase (LDH) and the site of distant metastases. Objective: Our aim was to compare the significance of metastatic volume, as evaluated at the time of stage IV melanoma diagnosis, with other clinical predictors of prognosis. Methods: We conducted a retrospective multicentric study. To establish which variables were statistically correlated both with death and survival time, contingency tables were evaluated. The overall survival curves were compared using the Kaplan-Meier method. Results: Metastatic volume and number of affected organs were statistically related to death. In detail, patients with a metastatic volume >15 cm³ had a worse prognosis than those with a volume lower than this value (survival probability at 60 months: 6.8 vs. 40.9%, respectively). The Kaplan-Meier method confirmed that survival time was significantly related to the site(s) of metastases, to elevated LDH serum levels and to melanoma stage according to the latest system. Conclusion: Our results suggest that metastatic volume may be considered as a useful prognostic factor for survival among melanoma patients.

Collapse of the Plasmacytoid Dendritic Cell Compartment in Advanced Cutaneous Melanomas by Components of the Tumor Cell Secretome

“…6G and H). In MM, the tumor burden predicts patient survival (33). The site of metastasis and LDH concentration characterize the M1a, M1b, and M1c categories, with the latter category showing an increased LDH and the worst prognosis (19).…”

TLR7 Gln11Leu single nucleotide polymorphism and susceptibility to cutaneous melanoma

“…In parallel with the increase in incidence rate, there has also been an increase in the rate of melanoma associated-mortality (2). Distant metastatic melanoma has a 5-year overall survival rate of only 5-10%, and a median survival of 6-10 months, depending on the site of metastasis (7).…”

Giant Centrifugal and Necrotizing Cutaneous Metastases of Melanoma

“…Local recurrences develop as an in situ component in contiguity with an excision scar or a graft; in-transit disease (satellitosis) indicates skin lesions between the primary site and the regional lymph nodes; and distant metastases are defined as neo-formations that grow in any skin site over the regional lymph nodes. 1 A wide morphological and clinical spectrum of cutaneous metastatic melanoma has been described in the literature.…”

“…The spread of malignant melanoma metastases occurs by both lymphogenous and hematogenous routes. 1 The skin and subcutaneous lymph nodes (59%) are most commonly involved, followed by lung (36%), brain (20%), liver (20%), bone (17%), and others (12%). [1][2][3] In the natural history of melanoma, cutaneous metastases occur relatively frequently and can arise in early or late stages of the disease.…”