Markus V Heppt1, Alexander Roesch2, Benjamin Weide3, Ralf Gutzmer4, Friedegund Meier5, Carmen Loquai6, Katharina C Kähler7, Anja Gesierich8, Markus Meissner9, Dagmar von Bubnoff10, Daniela Göppner11, Max Schlaak12, Claudia Pföhler13, Jochen Utikal14, Lucie Heinzerling15, Ioana Cosgarea16, Jutta Engel17, Renate Eckel18, Alexander Martens19, Laura Mirlach20, Imke Satzger21, Gabriele Schubert-Fritschle22, Julia K Tietze23, Carola Berking24. 1. Department of Dermatology and Allergy, Munich University Hospital (LMU), Frauenlobstr. 9-11, 80337 Munich, Germany. Electronic address: Markus.Heppt@med.uni-muenchen.de. 2. Department of Dermatology, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany; German Cancer Consortium (DKTK), Germany. Electronic address: alexander.roesch@uk-essen.de. 3. Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, Liebermeisterstr. 25, 72076 Tübingen, Germany. Electronic address: benjamin.weide@med.uni-tuebingen.de. 4. Department for Dermatology and Allergy, Skin Cancer Center Hannover (HTZH), Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: Gutzmer.Ralf@mh-hannover.de. 5. Department of Dermatology, Skin Cancer Center, National Center for Tumor Diseases, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Fetscherstr. 74, 01307 Dresden, Germany. Electronic address: Friedegund.Meier@uniklinikum-dresden.de. 6. Department of Dermatology, University Medical Center Mainz, Langenbeckstr. 1, 55131 Mainz, Germany. Electronic address: Carmen.Loquai@unimedizin-mainz.de. 7. Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Rosalind-Franklin-Str. 7, 24105 Kiel, Germany. Electronic address: kkaehler@dermatology.uni-kiel.de. 8. Department of Dermatology, University Hospital Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany. Electronic address: Gesierich_A@ukw.de. 9. Department of Dermatology, Venereology and Allergology, Goethe University, Theodor-Stern Kai 7, 60590 Frankfurt am Main, Germany. Electronic address: Markus.Meissner@kgu.de. 10. Department of Dermatology, Medical Center - University of Freiburg, Hauptstr. 7, 79104 Freiburg, Germany. Electronic address: dagmar.bubnoff@uniklinik-freiburg.de. 11. Department of Dermatology and Allergology, Justus Liebig University, University Medical Center Gießen and Marburg, Gaffkystr. 14, 35392 Gießen, Germany. Electronic address: Daniela.Goeppner@derma.med.uni-giessen.de. 12. Department of Dermatology and Venereology, Skin Cancer Center at the Center of Integrated Oncology (CIO) Köln Bonn, University Hospital of Cologne, Kerpener Str. 62, 50937 Cologne, Germany. Electronic address: max.schlaak@uk-koeln.de. 13. Saarland University Medical School, Department of Dermatology, Kirrberger Str. 100, 66421 Homburg, Saar, Germany. Electronic address: Claudia.Pfoehler@uniklinikum-saarland.de. 14. Skin Cancer Unit, German Cancer Research Center (DKFZ) and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Electronic address: Jochen.Utikal@umm.de. 15. Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Ulmenweg 18, 91054 Erlangen, Germany. Electronic address: Lucie.Heinzerling@uk-erlangen.de. 16. Department of Dermatology, University Hospital Essen, Hufelandstr. 55, 45122 Essen, Germany; German Cancer Consortium (DKTK), Germany. Electronic address: ioana.cosgarea@uk-essen.de. 17. Munich Cancer Registry (MCR) of the Munich Tumor Centre (TZM), Department of Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilian-University (LMU), Marchioninistr. 15, 81337 Munich, Germany. Electronic address: engel@ibe.med.uni-muenchen.de. 18. Munich Cancer Registry (MCR) of the Munich Tumor Centre (TZM), Department of Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilian-University (LMU), Marchioninistr. 15, 81337 Munich, Germany. Electronic address: eckel@ibe.med.uni-muenchen.de. 19. Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, Liebermeisterstr. 25, 72076 Tübingen, Germany. Electronic address: alexander.martens@med.uni-tuebingen.de. 20. Department of Dermatology and Allergy, Munich University Hospital (LMU), Frauenlobstr. 9-11, 80337 Munich, Germany. Electronic address: Laura.Mirlach@med.uni-muenchen.de. 21. Department for Dermatology and Allergy, Skin Cancer Center Hannover (HTZH), Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany. Electronic address: Satzger.Imke@mh-hannover.de. 22. Munich Cancer Registry (MCR) of the Munich Tumor Centre (TZM), Department of Medical Information Processing, Biometry and Epidemiology (IBE), University Hospital of Munich, Ludwig-Maximilian-University (LMU), Marchioninistr. 15, 81337 Munich, Germany. Electronic address: Gabriele.Schubert-Fritschle@med.uni-muenchen.de. 23. Department of Dermatology and Allergy, Munich University Hospital (LMU), Frauenlobstr. 9-11, 80337 Munich, Germany. Electronic address: Julia.Tietze@med.uni-muenchen.de. 24. Department of Dermatology and Allergy, Munich University Hospital (LMU), Frauenlobstr. 9-11, 80337 Munich, Germany. Electronic address: Carola.Berking@med.uni-muenchen.de.
Abstract
BACKGROUND: Mucosal melanoma (MM) is a rare but diverse cancer entity. Prognostic factors are not well established for Caucasians with MM. PATIENTS AND METHODS: We analysed the disease course of 444 patients from 15 German skin cancer centres. Disease progression was determined with the cumulative incidence function. Survival times were estimated with the Kaplan-Meier method. Prognostic parameters were identified with multivariate Cox regression analysis. RESULTS: Common anatomic sites of primary tumours were head and neck (MMHN, 37.2%), female genital tract (MMFG, 30.4%) and anorectal region (MMAN, 21.8%). MMAN patients showed the highest vertical tumour thickness (p = 0.001), had a more advanced nodal status (p = 0.014) and a higher percentage of metastatic disease (p = 0.001) at diagnosis. Mutations of NRAS (13.8%), KIT (8.6%) and BRAF (6.4%) were evenly distributed across all tumour site groups. Local relapses were observed in 32.4% and most commonly occurred in the MMHN group (p = 0.016). Male gender (p = 0.047), advanced tumour stage (p = 0.001), nodal disease (p = 0.001) and incomplete resection status (p = 0.001) were independent risk factors for disease progression. Overall survival (OS) was highest in the MMFG group (p = 0.030) and in patients without ulceration (p = 0.004). Multivariate risk factors for OS were M stage at diagnosis (p = 0.002) and incomplete resection of the primary tumour (p = 0.001). CONCLUSION: In this large series of MM patients in a European population, anorectal MM was associated with the poorest prognosis.
BACKGROUND:Mucosal melanoma (MM) is a rare but diverse cancer entity. Prognostic factors are not well established for Caucasians with MM. PATIENTS AND METHODS: We analysed the disease course of 444 patients from 15 German skin cancer centres. Disease progression was determined with the cumulative incidence function. Survival times were estimated with the Kaplan-Meier method. Prognostic parameters were identified with multivariate Cox regression analysis. RESULTS: Common anatomic sites of primary tumours were head and neck (MMHN, 37.2%), female genital tract (MMFG, 30.4%) and anorectal region (MMAN, 21.8%). MMAN patients showed the highest vertical tumour thickness (p = 0.001), had a more advanced nodal status (p = 0.014) and a higher percentage of metastatic disease (p = 0.001) at diagnosis. Mutations of NRAS (13.8%), KIT (8.6%) and BRAF (6.4%) were evenly distributed across all tumour site groups. Local relapses were observed in 32.4% and most commonly occurred in the MMHN group (p = 0.016). Male gender (p = 0.047), advanced tumour stage (p = 0.001), nodal disease (p = 0.001) and incomplete resection status (p = 0.001) were independent risk factors for disease progression. Overall survival (OS) was highest in the MMFG group (p = 0.030) and in patients without ulceration (p = 0.004). Multivariate risk factors for OS were M stage at diagnosis (p = 0.002) and incomplete resection of the primary tumour (p = 0.001). CONCLUSION: In this large series of MMpatients in a European population, anorectal MM was associated with the poorest prognosis.
Authors: Ozlen Saglam; Syeda M H Naqvi; Yonghong Zhang; Tania Mesa; Jamie K Teer; Sean Yoder; Jae Lee; Jane Messina Journal: Melanoma Res Date: 2018-12 Impact factor: 3.599
Authors: Carl M Thielmann; Eleftheria Chorti; Johanna Matull; Rajmohan Murali; Anne Zaremba; Georg Lodde; Philipp Jansen; Luisa Richter; Julia Kretz; Inga Möller; Antje Sucker; Rudolf Herbst; Patrick Terheyden; Jochen Utikal; Claudia Pföhler; Jens Ulrich; Alexander Kreuter; Peter Mohr; Ralf Gutzmer; Friedegund Meier; Edgar Dippel; Michael Weichenthal; Annette Paschen; Elisabeth Livingstone; Lisa Zimmer; Dirk Schadendorf; Eva Hadaschik; Selma Ugurel; Klaus G Griewank Journal: Eur J Cancer Date: 2021-11-04 Impact factor: 10.002
Authors: Priyadharsini Nagarajan; Jin Piao; Jing Ning; Laura E Noordenbos; Jonathan L Curry; Carlos A Torres-Cabala; A Hafeez Diwan; Doina Ivan; Phyu P Aung; Merrick I Ross; Richard E Royal; Jennifer A Wargo; Wei-Lien Wang; Rashmi Samdani; Alexander J Lazar; Asif Rashid; Michael A Davies; Victor G Prieto; Jeffrey E Gershenwald; Michael T Tetzlaff Journal: Mod Pathol Date: 2019-08-05 Impact factor: 7.842
Authors: Ji-Jin Yao; Fan Zhang; Guang-Shun Zhang; Xiao-Wu Deng; Wang-Jian Zhang; Wayne R Lawrence; Lu Zou; Xiao-Shi Zhang; Li-Xia Lu Journal: Cancer Manag Res Date: 2018-12-14 Impact factor: 3.989
Authors: Piotr Donizy; Cheng-Lin Wu; Jason Mull; Masakazu Fujimoto; Agata Chłopik; Yan Peng; Sara C Shalin; M Angelica Selim; Susana Puig; Maria-Teresa Fernandez-Figueras; Christopher R Shea; Wojciech Biernat; Janusz Ryś; Andrzej Marszalek; Mai P Hoang Journal: Cells Date: 2020-05-05 Impact factor: 6.600