Abstract 1119P
Background
The classification of stage III melanoma has significantly changed in the American Joint Committee on Cancer 8th version (AJCC v8). Besides including four new substages, AJCC v8 defines that lymph nodes (LN) with metastatic tumor cells, regardless of the size and the technic used to identify it, should be considered tumor-involved LN. This implies that even thin melanomas with isolated tumor cells (ic) in LN will be classified as stage IIIA, potentially upstaging patients (pts) with good prognosis.
Methods
Patients with cutaneous melanoma diagnosed with stage I-III between 2000-2020 at the Centre of Dermatooncology, University-Hospital of Tuebingen, were included. A cohort of stage IIIA (ic) pts from the DeCOG trial was used as a validation cohort. Relapse-free survival (RFS) and distant metastasis-free survival (DMFS) were evaluated using Kaplan-Meier estimates. Data on pts and tumor characteristics will also be presented.
Results
The Tuebingen cohort included 106 pts with stage IIIA (ic) and 132 pts with stage IIIA with a LN metastasis >0.1 mm (from now on stage IIIA). The validation cohort from the DeCOG trial consisted of 39 pts with melanoma IIIA (ic) and 104 pts with stage IIIA. The median follow-up (mFU) for stage IIIA (ic) and IIIA in the CMMR cohort was 64 and 60 months (95% CI 34-97 and 35-106), respectively. The mFU for stage IIIA (ic) and IIIA in the DeCOG cohort was 64 and 62 months (95%CI 47-95 and 37-86), respectively. In the Tuebingen cohort, 10y RFS rates for stage IIIA (ic) and IIIA were 82% (95% CI 72-92) and 48% (95% CI 38-58), respectively (p<0.001). The 10y DMFS rates for stage IIIA (ic) and IIIA were 87% (95% CI 79-96) and 55% (95% CI 44-66), respectively; (p<0.001). In the DeCOG cohort, 10y RFS for stage IIIA (ic) and stage IIIA were 88% (95% CI 77-99) and 35% (95% CI 7-62), respectively; (p=0.009). The 10y DMFS for stage IIIA (ic) and IIIA was 88% (95% CI 77-99) and 60% (95% CI 39-80), respectively (p=0.061).
Conclusions
AJCCv8 Stage IIIA (ic) melanoma has a prognosis similar to stage IB, statistically significantly better than Stage IIIA. LN with isolated tumor cells should not be considered tumor-involved LN, and this should be reviewed in the new AJCC edition.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
T.M.S. Amaral: Financial Interests, Personal, Writing Engagement: CeCaVa; Financial Interests, Personal, Invited Speaker: BMS, Novartis, Pierre Fabre; Financial Interests, Institutional, Funding: Novartis, Neracare, Sanofi, Skyline-Dx; Financial Interests, Institutional, Research Grant: Novartis, iFIT; Financial Interests, Institutional, Local PI: IO Biotech, MSD, University Hospital, Essen, Roche; Financial Interests, Institutional, Coordinating PI: Unicancer; Non-Financial Interests, Member: Portuguese Society for Medical Oncology, ASCO; Other, Clinical expert: INFARMED. R. Stadler: Financial Interests, Personal, Advisory Board: Kyowa Kirin, Stemline, 4SC. A. Forschner: Financial Interests, Personal and Institutional, Invited Speaker: Pierre Fabre, Novartis, MSD, BMS; Financial Interests, Institutional, Advisory Board: Immunocore, Pierre Fabre, MSD, BMS, Novartis; Financial Interests, Institutional, Research Grant: BMS Stiftung Immunonkologie; Financial Interests, Personal, Other, Travel, Accommodation, Expenses: Pierre Fabre, Novartis. L. Flatz: Financial Interests, Personal, Stocks or ownership: Hookipa Pharma; Financial Interests, Personal, Invited Speaker: BMS, Novartis, Sanofi; Financial Interests, Personal, Advisory Board: BMS, Novartis, Sanofi, Philogen; Financial Interests, Institutional, Research Funding: Hookipa Pharma; Financial Interests, Personal, Royalties: Hookipa Pharma. C. Garbe: Financial Interests, Personal, Advisory Board: CeCaVa, Novartis, NeraCare, BMS, Philogen, Roche, Sanofi, MSD. U. Leiter-Stoppke: Financial Interests, Institutional, Research Grant: MSD; Financial Interests, Personal, Invited Speaker: MSD, Novartis, Sun Pharma, Allmiral Hermal, Sanofi; Financial Interests, Personal, Other, Travel support: Sun Pharma; Financial Interests, Personal, Advisory Board: MSD, Novartis, Sun Pharma, Allmiral Hermal, Sanofi; Non-Financial Interests, Personal, Other, Board member: ADO (DECOG). All other authors have declared no conflicts of interest.
Resources from the same session
1171P - Evaluation of the transcriptomic presence of tumor associated antigens (TAAs) from antibody drug conjugates (ADCs) and PD-L1 in melanoma: Options for new clinical opportunities
Presenter: Jorge Bartolome
Session: Poster session 13
1172P - Analysis of the microbiome of metastatic melanoma patients with complete response to immunotherapy
Presenter: Marin Golcic
Session: Poster session 13
1173P - NRAS mutation as an independent prognostic factor for resectable Chinese acral melanoma
Presenter: Yu Xu
Session: Poster session 13
1174P - Sex differences in advanced melanoma in Spain: Results from the prospective real-world study GEM 1801
Presenter: Eva Muñoz Couselo
Session: Poster session 13
1175P - Return to work after neoadjuvant versus adjuvant immunotherapy in stage III melanoma patients
Presenter: Judith Lijnsvelt
Session: Poster session 13
1176P - Planned drug holidays during immunotherapy in advanced and metastatic melanoma patients: A nation-wide study
Presenter: Anna Czarnecka
Session: Poster session 13
1177P - Assessment of tumour burden reduction per photography vs magnetic resonance imaging in patients with locally advanced basal cell carcinoma receiving sonidegib 200 mg
Presenter: Ralf Gutzmer
Session: Poster session 13
1178P - Melanoma incidence rises for pediatrics: 15-year nationwide retrospective cohort study in Korea (2004-2019)
Presenter: Jisu Oh
Session: Poster session 13
1179P - The underestimated skin cancer risk after liver transplantation: A meta-analysis of 147154 patients
Presenter: Amr Ehab El-Qushayri
Session: Poster session 13