1121P - Prognostic effect of primary tumor characteristics in metastatic melanoma

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Skin cancers
Melanoma
Presenter Burcak Karaca
Citation Annals of Oncology (2014) 25 (suppl_4): iv374-iv393. 10.1093/annonc/mdu344
Authors B. Karaca1, Z. Surmeli2, A. Erdoğan3, U.A. Sanli2, C. Sezgin2, R. Uslu2
  • 1Medical Oncology, Ege University, School of Medicine, 35100 - izmir/TR
  • 2Division Of Medical Oncology, Ege University, School of Medicine,Tulay Aktas Oncology Hospital, 35100 - izmir/TR
  • 3Medical Oncology, Ege University, School of Medicine, izmir/TR

Abstract

Aim

Prognostic effect of pathological and clinical parameters of the primary tumor is well-defined in localized melanoma. In this study we analyzed the effect of these parameters on survival duration in metastatic melanoma.

Methods

Records of cutaneous metastatic melanoma patients diagnosed between 2006 - 2013 in our center were reviewed. Patients with pathological data of the primary melanoma lesion were included in the study. We analyzed the effect of pathological and clinical parameters on disease-specific survival (DSS). DSS was measured from diagnosis of metastatic melanoma to death.

Results

140 patients were included in the study. At a median follow-up duration of 28 months, 88 deaths were observed. DSS of the patient population was 16 months (95% CI: 13.3–18.7). Male patients had a shorter median DSS (14.4 vs. 19.4 months, p: 0.046). DSS was similar in patients aged under and over 60 years. Presence of ulceration of the primary lesion was associated with worse median survival duration (15 vs. 22.3 months, p: 0.006). Mitotic count of less than 5/mm2 was associated with longer median DSS compared with 5 or more mitoses/mm2 (22.3 vs. 13.2, p: 0.013). Breslow thickness (≤2 mm vs. >2 mm) was not found to have a prognostic effect; however, patients with regional lymph node metastases at the time of diagnosis had shorter median DSS duration (13.5 vs. 23 months, p: 0.035). Localization of the primary tumor, histological subtype and presence of regression were not associated with DSS in metastatic melanoma. In multivariate analysis, presence of ulceration (HR: 2.54, 95%CI: 1.2–5.3), and mitotic count of 5 or more (HR: 2.43, 95%CI: 1.1–5.4) were associated with decreased DSS.

Conclusions

Presence of ulceration, high mitotic count (≥5/mm2) and presence of regional lymph node metastases at the time of diagnosis are among the well-known prognostic factors in localized melanoma. Our results support that these factors may portend poor prognosis also in metastatic melanoma. These parameters may be associated with tumor biology and may indicate more aggressive disease.

Disclosure

All authors have declared no conflicts of interest.