Abstract 1793
Background
Changes to the AJCC melanoma staging system eighth edition (AJCC-8) should be independently validated to assess its prognostic performance compared with the seventh edition (AJCC-7) in accurately staging melanoma.
Methods
We used the SEER-18 registry from 2010 to 2015 to extract patient-, tumour-related and survival data. Kaplan-Meier analysis was used for overall survival (OS) and cancer-specific survival (CSS) for AJCC-7 and AJCC-8. Cumulative hazard functions were computed using Nelson-Aalen function.
Results
Of 126,408 individuals, 59,989 (47%) and 60,411 (48%) had available data for pathological and clinical stage OS analysis, respectively. The 12-month OS for AJCC-7 among pathologically staged patients were: stage IA 99%, stage IB 99%, stage IIA 96%, stage IIB 94%, stage IIC 87%, stage IIIA 98%, stage IIIB 94%, stage IIIC 82% and stage IV 41%. The 12-month OS for AJCC-8 patients was similar to AJCC-7 but was 88% for stage IIIC and 65% for stage IIID. The 12-month risk of dying for pathological stage IIIC was 13% compared to 41% for pathological stage IIID (p < 0.001). Stage IV individuals with an elevated LDH had worse OS and CSS at all other measured time-points up to 60 months compared to those with a normal LDH. Stage IV individuals with brain metastases (M1d) also had worse OS and CSS at all other measured time-points up to 60 months compared to other stage IV subgroups.
Conclusions
The discriminatory ability of the AJCC-7 and AJCC-8 melanoma staging system appear comparable. Changes in AJCC-8 identifies individuals with a poorer prognostic within new subgroups. These include the subgroups of stage IIID and M1d within stage IV individuals, and the addition of elevated LDH as a prognostic marker in stage IV disease. However, advanced T stage, node-negative tumours experienced worse survival compared with earlier T stage, node-positive tumours requiring further research to evaluate the underlying biology of these tumour subgroups.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
2421 - Lenvatinib plus PD-1 blockade in advanced bile tract carcinoma.
Presenter: Jianzhen Lin
Session: Poster Display session 3
Resources:
Abstract
5368 - Durvalumab and Paclitaxel Combination for treatment of metastatic triple negative breast cancer is safe with very promising efficacy
Presenter: Hazem Ghebeh
Session: Poster Display session 3
Resources:
Abstract
1520 - A prospective cohort study on the pharmacokinetics of nivolumab in metastatic non-small cell lung cancer, melanoma, and renal cell cancer patients
Presenter: Daan Hurkmans
Session: Poster Display session 3
Resources:
Abstract
1603 - Safety and clinical activity of subcutaneously (SC) administered anti-PD-1 antibody PF-06801591 in phase I dose-expansion cohorts of locally advanced or metastatic non-small-cell lung cancer (NSCLC) and urothelial carcinoma (UC)
Presenter: Byoung Cho
Session: Poster Display session 3
Resources:
Abstract
3922 - Development of the Functional Assessment of Cancer Therapy-Immune Checkpoint Modulator (FACT-ICM): A scale to measure quality of life in cancer patients treated with ICMs
Presenter: Aaron Hansen
Session: Poster Display session 3
Resources:
Abstract
2408 - Immune checkpoint inhibitors (ICIs) as “chemotherapy (Ctx) sensitization” strategy in advanced solid tumors
Presenter: Francisco Javier Ros Montana
Session: Poster Display session 3
Resources:
Abstract
3612 - Validation of progression-free survival (PFS) as surrogate endpoint in randomised trials of immune checkpoint inhibitors in advanced solid cancers
Presenter: Peey Sei Kok
Session: Poster Display session 3
Resources:
Abstract
3827 - Pharmacokinetic (PK) analysis of weight-based and fixed dose cemiplimab in patients (pts) with advanced malignancies
Presenter: Michael Migden
Session: Poster Display session 3
Resources:
Abstract
2120 - A burst of highly differentiated CD4 TL identifies a subset of fast progressors, and correlates with hyperprogressive disease in NSCLC patients treated with ICI
Presenter: Hugo Arasanz
Session: Poster Display session 3
Resources:
Abstract
4254 - Nivolumab treatment in advanced non-small cell lung cancer (aNSCLC): a French nationwide retrospective cohort (UNIVOC Study)
Presenter: Christos Chouaid
Session: Poster Display session 3
Resources:
Abstract