Comparison of clinicopathological features and treatment outcomes for cutaneous melanomas of the head and neck and melanomas arising at other sites: Implications for systemic therapy.

Autor:	Li AT; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia., Xu JX; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Royal Prince Alfred Hospital, Camperdown, NSW, Australia., Blah TR; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia., Lo SN; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia., Saw RP; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Mater Hospital, Sydney, NSW, Australia., Varey AH; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Westmead and Blacktown Hospitals, Sydney, NSW, Australia., Van Akkooi A; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Mater Hospital, Sydney, NSW, Australia., Carlino MS; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Westmead and Blacktown Hospitals, Sydney, NSW, Australia., Pires da Silva I; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Mater Hospital, Sydney, NSW, Australia; Westmead and Blacktown Hospitals, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia., Menzies AM; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Mater Hospital, Sydney, NSW, Australia; Royal North Shore Hospital, St Leonards, NSW, Australia., Shannon KF; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Mater Hospital, Sydney, NSW, Australia., Long GV; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Mater Hospital, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia; Royal North Shore Hospital, St Leonards, NSW, Australia., Scolyer RA; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia; NSW Health Pathology, Sydney, NSW, Australia., Thompson JF; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Mater Hospital, Sydney, NSW, Australia; Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia., Ch'ng S; Melanoma Institute Australia, The University of Sydney, North Sydney, NSW, Australia; Royal Prince Alfred Hospital, Camperdown, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Mater Hospital, Sydney, NSW, Australia; Chris O'Brien Lifehouse Cancer Centre, Camperdown, NSW, Australia. Electronic address: sydney.chng@sydney.edu.au.
Jazyk:	angličtina
Zdroj:	Journal of the American Academy of Dermatology [J Am Acad Dermatol] 2024 Sep 06. Date of Electronic Publication: 2024 Sep 06.
DOI:	10.1016/j.jaad.2024.06.107
Abstrakt:	Background: Melanoma is increasingly recognized as a heterogeneous disease, with conflicting evidence regarding whether cutaneous head and neck melanoma (CHNM) represents a distinct entity. Objective: Comparison of clinicopathological features and treatment outcomes of CHNM and cutaneous melanomas of other sites (CMOS). Methods: Patients with CHNM and CMOS diagnosed between 2000 and 2018 were included. Locoregional control, distant metastasis-free survival, melanoma-specific survival (MSS), and overall survival (OS) were described using the Kaplan-Meier method. Cox regression analyses were performed to examine associations between prognostic factors and outcomes. Additional analyses of survival from time of stage IV disease diagnosis were undertaken, stratified by receipt of BRAF-targeted therapy and immune checkpoint inhibitor immunotherapy. Results: Of 3007 CHNM and 10,637 CMOS patients, CHNM had more adverse pathological features (median age 65.9 vs 58.5, P < .001; median Breslow thickness 1.7 mm vs 1.2 mm, P < .001; and ulceration 21.2% vs 18.2%, P < .001). CHNM had worse locoregional control (hazard ratio (HR) 1.17, P < .001) and distant metastasis-free survival (HR 1.25, P < .001) but there were no significant differences in MSS or OS. Among stage IV patients who received immune checkpoint inhibitor, CHNM had better MSS (HR 0.56, P = .001) and OS (HR 0.57, P < .001) on multivariable analyses. Limitations: Retrospective study, offset by prospective data collection. Conclusion: CHNM is associated with a distinct clinicopathological and prognostic profile. Competing Interests: Conflicts of interest Dr Saw has received honoraria for advisory board participation from MSD, Novartis, and Qbiotics and speaking honoraria from BMS and Novartis. Dr Pires da Silva has received travel support from BMS and MSD and speaker fees from Roche, BMS, MSD, and Novartis. Dr Varey has received an honorarium from Novartis. Dr Akkooi has served on advisory boards and received consultancy honoraria from Amgen, Bristol Myers Squibb, Neracare, Novartis, MSD-Merck, Merck-Pfizer, Pierre Fabre, Provectus, Sanofi, Sirius Medical, and 4SC. Dr Menzies has served on advisory boards for BMS, MSD, Novartis, Roche, Pierre-Fabre, and QBiotics. Dr Carlino has served on advisory boards for Bristol-Myers Squibb, MSD, Amgen, Novartis, Pierre Fabre, Roche, Sanofi, Merck, Ideaya, Regeneron, Nektar, Eisai, Oncosec, and Qbiotics and honoraria from Bristol-Myers Squibb, MSD, and Novartis. Dr Long is consultant advisor for Agenus, Amgen, Array Biopharma, AstraZeneca, Boehringer Ingelheim, Bristol Myers Squibb, Evaxion, Hexal AG (Sandoz Company), Highlight Therapeutics S.L., Innovent Biologics USA, Merck Sharpe & Dohme, Novartis, OncoSec, PHMR Ltd, Pierre Fabre, Provectus, Qbiotics, and Regeneron. Dr Scolyer has received fees for professional services from MetaOptima Technology Inc., F. Hoffmann-La Roche Ltd, Evaxion, Provectus Biopharmaceuticals Australia, Qbiotics, Novartis, Merck Sharp & Dohme, NeraCare, AMGEN Inc., Bristol-Myers Squibb, Myriad Genetics, and GlaxoSmithKline. Dr Thompson has received honoraria for advisory board participation from BMS Australia, MSD Australia, GSK, and Provectus Biopharmaceuticals, and travel and conference support from GSK, Provectus Biopharmaceuticals, and Novartis. Drs Li, Xu, Blah, Lo, Shannon, and Ch'ng have no conflicts of interest to declare. (Copyright © 2024 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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