Andrew T Li, Jessie X Xu, Tyler R Blah, Serigne N Lo, Robyn Pm Saw, Alexander Hr Varey, Alexander Van Akkooi, Matteo S Carlino, Ines Pires da Silva, Alexander M Menzies, Kerwin F Shannon, Georgina V Long, Richard A Scolyer, John F Thompson, Sydney Ch'ng
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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.</p><p><strong>Results: </strong>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.</p><p><strong>Limitations: </strong>Retrospective study, offset by prospective data collection.</p><p><strong>Conclusion: </strong>CHNM is associated with a distinct clinicopathological and prognostic profile.</p>","PeriodicalId":17198,"journal":{"name":"Journal of the American Academy of Dermatology","volume":" ","pages":"58-67"},"PeriodicalIF":12.8000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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.\",\"authors\":\"Andrew T Li, Jessie X Xu, Tyler R Blah, Serigne N Lo, Robyn Pm Saw, Alexander Hr Varey, Alexander Van Akkooi, Matteo S Carlino, Ines Pires da Silva, Alexander M Menzies, Kerwin F Shannon, Georgina V Long, Richard A Scolyer, John F Thompson, Sydney Ch'ng\",\"doi\":\"10.1016/j.jaad.2024.06.107\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Melanoma is increasingly recognized as a heterogeneous disease, with conflicting evidence regarding whether cutaneous head and neck melanoma (CHNM) represents a distinct entity.</p><p><strong>Objective: </strong>Comparison of clinicopathological features and treatment outcomes of CHNM and cutaneous melanomas of other sites (CMOS).</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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. 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引用次数: 0
摘要
背景:黑色素瘤越来越被认为是一种异质性疾病:黑色素瘤越来越被认为是一种异质性疾病,关于皮肤头颈部黑色素瘤(CHNM)是否代表一个独特的实体,存在相互矛盾的证据:比较头颈部皮肤黑色素瘤和其他部位皮肤黑色素瘤(CMOS)的临床病理特征和治疗效果:纳入2000-2018年间确诊的CHNM和CMOS患者。采用 Kaplan-Meier 法描述了局部控制率(LRC)、无远处转移生存率(DMFS)、黑色素瘤特异性生存率(MSS)和总生存率(OS)。研究人员还进行了 Cox 回归分析,以检验预后因素与结果之间的关联。此外,还根据接受 BRAF 靶向疗法和免疫检查点抑制剂(ICI)免疫疗法的情况,对 IV 期疾病诊断后的存活率进行了分析:结果:在3007名CHNM和10637名CMOS患者中,CHNM患者的不良病理特征更明显(中位年龄65.9岁对58.5岁,p局限性:局限性:回顾性研究,由前瞻性数据收集抵消:结论:CHNM 与独特的临床病理和预后特征相关。
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.
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.
期刊介绍:
The Journal of the American Academy of Dermatology (JAAD) is the official scientific publication of the American Academy of Dermatology (AAD). Its primary goal is to cater to the educational requirements of the dermatology community. Being the top journal in the field, JAAD publishes original articles that have undergone peer review. These articles primarily focus on clinical, investigative, and population-based studies related to dermatology. Another key area of emphasis is research on healthcare delivery and quality of care. JAAD also highlights high-quality, cost-effective, and innovative treatments within the field. In addition to this, the journal covers new diagnostic techniques and various other topics relevant to the prevention, diagnosis, and treatment of skin, hair, and nail disorders.