Factors Affecting Recurrence and Survival for Patients with High-Risk Stage II Melanoma.

Autor: Dedeilia A; Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA., Lwin T; Division of Surgical Oncology, City of Hope National Medical Center, Duarte, CA, USA., Li S; Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Tarantino G; Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA.; Department of Medical Oncology, Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA., Tunsiricharoengul S; Harvard University, Boston, MA, USA., Lawless A; Cancer Center, Massachusetts General Hospital, Boston, MA, USA., Sharova T; Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA., Liu D; Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA.; Department of Medical Oncology, Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, MA, USA., Boland GM; Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA.; Harvard Medical School, Boston, MA, USA.; Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA., Cohen S; Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Massachusetts General Hospital, Boston, MA, USA. scohen22@mgh.harvard.edu.; Harvard Medical School, Boston, MA, USA. scohen22@mgh.harvard.edu.; Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, MA, USA. scohen22@mgh.harvard.edu.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2024 Apr; Vol. 31 (4), pp. 2713-2726. Date of Electronic Publication: 2023 Dec 29.
DOI: 10.1245/s10434-023-14724-5
Abstrakt: Background: In the current era of effective adjuvant therapies and de-escalation of surgery, distinguishing which patients with high-risk stage II melanoma are at increased risk of recurrence after excision of the primary lesion is essential to determining appropriate treatment and surveillance plans.
Methods: A single-center retrospective study analyzed patients with stage IIB or IIC melanoma. Demographic and tumor data were collected, and genomic analysis of formalin-fixed, paraffin-embedded tissue samples was performed via an internal next-generation sequencing (NGS) platform (SNaPshot). The end points examined were relapse-free survival (RFS), distant metastasis-free survival (DMFS), overall survival (OS), and melanoma-specific survival (MSS). Uni- and multivariable Cox regressions were performed to calculate the hazard ratios.
Results: The study included 92 patients with a median age of 69 years and a male/female ratio of 2:1. A Breslow depth greater than 4 mm, a higher mitotic rate, an advanced T stage, and a KIT mutation had a negative impact on RFS. A primary lesion in the head and neck, a mitotic rate exceeding 10 mitoses per mm 2 , a CDH1 mutation, or a KIT mutation was significantly associated with a shorter DMFS. Overall survival was significantly lower with older age at diagnosis and a higher mitotic rate. An older age at diagnosis also had a negative impact on MSS.
Conclusion: Traditional histopathologic factors and specific tumor mutations displayed a significant correlation with disease recurrence and survival for patients with high-risk stage II melanoma. This study supported the use of genomic testing of high-risk stage II melanomas for prognostic prediction and risk stratification.
(© 2023. The Author(s).)
Databáze: MEDLINE
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