Prognostic factors for postoperative survival in melanoma patients with bone metastasis

Abstract

Melanoma can spread to the bone by metastasis and is relevant to a poor outcome. However, because of the rarity of melanoma patients with bone metastasis, the prognostic postoperative survival factors of them have not been elucidated. The aim of this special population-based cohort was to elucidate the prognostic factors associated with postoperative survival. The Surveillance, Epidemiology, and End Results database was used to extract postoperative survival data relating to patients with melanoma and bone metastasis at diagnosis between 2010 and 2016, along with data on a range of potential postoperative prognostic factors. We then investigated the potential postoperative prognostic roles of these factors using a Cox regression model and the Kaplan-Meier analysis. In all, the Surveillance, Epidemiology, and End Results database included 186 cases. Regarding overall survival, the 1-, 3-, and 5-year overall survival rates for the entire cohort were 36.2%, 15.4%, and 9.5%, respectively. Regarding cancer-specific survival, the 1-, 3-, and 5-year cancer-specific survival rates were 42.0%, 23.2%, and 16.6%, respectively. Within a cohort of melanoma patients with bone metastasis after surgery, our analysis showed that a smaller tumor size and the lack of metastases at other sites were predictors of survival.

Evidências sobre o tratamento cirúrgico do melanoma metastático / Evidence on surgical treatment of metastatic melanoma

“…O pâncreas e o baço são sítios raros de metástases de melanoma, há uma escassez de literatura a respeito da cirurgia para metástases de melanoma para o pâncreas e baço. Há, também, uma escassez de literatura a respeito da cirurgia para metástases ósseas de melanoma, visto que metástases ósseas são incomuns e o prognóstico tem sido historicamente ruim 8 . A cirurgia com intenção curativa quase nunca é indicada.…”

“…A doença do sistema nervoso central (M1d) inclui metástases à distância para o cérebro ou medula espinhal. Mais de 50% dos pacientes com melanoma em estágio IV desenvolverão metástases cerebrais, que podem ser assintomáticas ou apresentar dor de cabeça, convulsão, déficits neurológicos ou alterações de comportamento 7,8 . O prognóstico tem sido historicamente pobre, com uma sobrevida global mediana de três a sete meses com tratamento sistêmico sozinho na era anterior às terapias contemporâneas de bloqueio de ponto de controle Brazilian Journal of Health Review, Curitiba, v.5, n.1, p.1176-1189 jan./feb.…”

“…Os pacientes que são submetidos à ressecção completa da doença metastática com sucesso permanecem em alto risco de doença metastática recorrente, para aqueles que reaparecem após um intervalo sem doença após a ressecção completa da doença metastática à distância, uma segunda metastasectomia pode oferecer um benefício de sobrevida em pacientes cuidadosamente selecionados 8,9,10 .…”

The promotive role of lncRNA MIR205HG in proliferation, invasion, and migration of melanoma cells via the JMJD2C/ALKBH5 axis

“…Despite the improvement of systemic therapy, the clinical outcome for advanced melanoma remains unsatisfactory [ 4 ]. Patients with high tumor burden and bone metastasis still have poor prognosis, with 5-year postoperative survival about 9.5% [ 5 ]. Given this scenario, the identification of effective therapeutic targets, especially factors targeting cell invasion and metastasis, remains in urgent need to improve clinical response of melanoma treatment.…”