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Zhu Z, Wang W, Zha Y, Wang X, Aodeng S, Wang L, Liu Y, Lv W. Development and validation of a nomogram for predicting overall survival in patients with sinonasal mucosal melanoma. BMC Cancer 2024; 24:184. [PMID: 38326751 PMCID: PMC10851497 DOI: 10.1186/s12885-024-11888-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/16/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Sinonasal mucosal melanoma (SNMM) is a relatively rare malignant tumour with a poor prognosis. This study was designed to identify prognostic factors and establish a nomogram model to predict the overall survival (OS) of patients with SNMM. METHODS A total of 459 patients with SNMM were selected from the Surveillance, Epidemiology, and End Results (SEER) database as the training cohort. Univariate and multivariate Cox regression analyses were used to screen for independent factors associated with patient prognosis and develop the nomogram model. In addition, external validation was performed to evaluate the effectiveness of the nomogram with a cohort of 34 patients with SNMM from Peking Union Medical College Hospital. RESULTS The median OS in the cohort from the SEER database was 28 months. The 1-year, 3-year and 5-year OS rates were 69.8%, 40.4%, and 30.0%, respectively. Multivariate Cox regression analysis indicated that age, T stage, N stage, surgery and radiotherapy were independent variables associated with OS. The areas under the receiver operating characteristic curves (AUCs) of the nomograms for predicting 1-, 3- and 5-year OS were 0.78, 0.71 and 0.71, respectively, in the training cohort. In the validation cohort, the area under the curve (AUC) of the nomogram for predicting 1-, 3- and 5-year OS were 0.90, 0.75 and 0.78, respectively. Patients were classified into low- and high-risk groups based on the total score of the nomogram. Patients in the low-risk group had a significantly better survival prognosis than patients in the high-risk group in both the training cohort (P < 0.0001) and the validation cohort (P = 0.0016). CONCLUSION We established and validated a novel nomogram model to predict the OS of SNMM patients stratified by age, T stage, N stage, surgery and radiotherapy. This predictive tool is of potential importance in the realms of patient counselling and clinical decision-making.
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Affiliation(s)
- Zhenzhen Zhu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No.1, Shuaifuyuan, Wangfujing, Dongcheng District, 100730, Beijing, China
| | - Weiqing Wang
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No.1, Shuaifuyuan, Wangfujing, Dongcheng District, 100730, Beijing, China
| | - Yang Zha
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No.1, Shuaifuyuan, Wangfujing, Dongcheng District, 100730, Beijing, China
| | - Xiaowei Wang
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No.1, Shuaifuyuan, Wangfujing, Dongcheng District, 100730, Beijing, China
| | - Surita Aodeng
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No.1, Shuaifuyuan, Wangfujing, Dongcheng District, 100730, Beijing, China
| | - Lei Wang
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No.1, Shuaifuyuan, Wangfujing, Dongcheng District, 100730, Beijing, China
| | - Yuzhuo Liu
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No.1, Shuaifuyuan, Wangfujing, Dongcheng District, 100730, Beijing, China
| | - Wei Lv
- Department of Otolaryngology-Head and Neck Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, No.1, Shuaifuyuan, Wangfujing, Dongcheng District, 100730, Beijing, China.
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Rojas-Lechuga MJ, Gras-Cabrerizo JR, Aviles-Jurado FX, Malvehy J, Arance AM, Castillo P, Barreiro A, Podlipnik S, Lopez-Chacon M, Alobid I, Bernal-Sprekelsen M, Puig S, Langdon C. Sinonasal mucosal melanomas: defining profiles for better survival outcomes. Rhinology 2022; 60:347-356. [PMID: 36184882 DOI: 10.4193/rhin21.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Sinonasal mucosal melanoma is an aggressive malignancy with a 5-year survival rate ranging from 20% to 39%. Despite the evolving surgical and radiotherapy techniques, and introduction of immune-checkpoint inhibitor therapy, overall survival rates remain poor. METHODOLOGY A retrospective cohort study was conducted at the Hospital Clinic de Barcelona and the Hospital de la Santa Creu i Sant Pau between 1984 and 2020; primary outcome measures were 3 and 5-year melanoma-specific survival (MSS). Kaplan-Meier survival analysis and Cox proportional hazards model were performed to identify predictors of survival. RESULTS Fifty patients were included, the mean age was 70.4, MSS at 3 and 5 years was 51.2%, and 29.5%, respectively. The median follow-up was 39.6 months during which 46% presented locoregional recurrence and 36%, metastasis. The univariate and multivariate analyses found as survival predictors the N category, the treatment received, the surgical margins and the mitotic index. CONCLUSIONS We found an overall 5-year MSS of 29.5%. Those patients with intention-to-cure (stages III and IVa) treated by surgery that were N0 at diagnosis, with < 10 mitoses per HPF showed a 5-year MSS rate of 74.1%. More studies will be needed to adequately define the patients' profiles that will benefit from a better survival outcome.
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Affiliation(s)
- M J Rojas-Lechuga
- Otorhinolaryngology Department, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - J R Gras-Cabrerizo
- Otorhinolaryngology Head-Neck Surgery Department, Hospital de la Santa Creu i Sant Pau, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - F X Aviles-Jurado
- Otorhinolaryngology Department, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
- Head Neck Clínic, University and Research Grants Management Agency (AGAUR), 2017-SGR-01581
- and Center for Biomedical Research Network on Diabetes and Metabolic Diseases (CIBERDEM), Barcelona, Spain
| | - J Malvehy
- Melanoma Unit, Department of Dermatology, Hospital Clinic de Barcelona, IDIBAPS, Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - A M Arance
- Oncology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - P Castillo
- Pathology Department, Hospital Clinic de Barcelona, IDIBAPS, Barcelona, Spain
| | - A Barreiro
- Melanoma Unit, Department of Dermatology, Hospital Clinic de Barcelona, IDIBAPS, Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - S Podlipnik
- Melanoma Unit, Department of Dermatology, Hospital Clinic de Barcelona, IDIBAPS, Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - M Lopez-Chacon
- Otorhinolaryngology Department, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - I Alobid
- Otorhinolaryngology Department, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - M Bernal-Sprekelsen
- Otorhinolaryngology Department, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - S Puig
- Melanoma Unit, Department of Dermatology, Hospital Clinic de Barcelona, IDIBAPS, Centre of Biomedical Research on Rare Diseases (CIBERER), ISCIII, Barcelona, Spain
| | - C Langdon
- Otorhinolaryngology Department, Hospital Clinic de Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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Salari B, Foreman RK, Emerick KS, Lawrence DP, Duncan LM. Sinonasal Mucosal Melanoma: An Update and Review of the Literature. Am J Dermatopathol 2022; 44:424-432. [PMID: 35315370 DOI: 10.1097/dad.0000000000002157] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Primary sinonasal mucosal melanoma (SNMM) is an aggressive tumor with high metastatic potential and poor outcomes. Presenting symptoms are nonspecific, and the nasal cavity is the most common site of origin followed by the maxillary and ethmoid sinuses. Histopathologically, SNMMs are pleomorphic and predominantly composed of epithelioid cell type. Identifying these tumors requires a high index of suspicion for melanoma and the use of a panel of immunohistochemical markers when typical histopathological features are missing. Not infrequently, these tumors are undifferentiated and/or amelanotic. Currently, SNMM falls into 2 different staging systems proposed by the American Joint Committee on Cancer, one for carcinoma of the nasal cavity and sinuses and the other for head and neck melanoma. Although therapeutic standards do not exist, surgical resection with adjuvant radiotherapy and/or systemic therapy may offer the best outcome. Lymphadenectomy including possible parotidectomy and neck dissection should be considered in patients with regional lymph node metastasis. However, the role of elective lymph node dissection is controversial. Genetic profiling has identified a number of recurrent gene mutations that may prove useful in providing targets for novel, emerging biological treatments. In this article, we provide an update on clinicopathological features, staging, molecular discoveries, and treatment options for SNMM.
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Affiliation(s)
- Behzad Salari
- Department of Pathology and Immunology, School of Medicine, Washington University Medical Center, St. Louis, MO
| | - Ruth K Foreman
- Pathology Service, Dermatopathology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Kevin S Emerick
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Harvard Medical School; and
| | - Donald P Lawrence
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Lyn M Duncan
- Pathology Service, Dermatopathology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
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Zhang Q, Zhu H, Zhang C, Wang Y, He Y, Li G. Ultrastructural and clinical features of central nervous system melanoma:Analysis of nine cases. Ultrastruct Pathol 2021; 45:79-89. [PMID: 33588681 DOI: 10.1080/01913123.2021.1874083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To investigate the ultrastructural and clinical characteristics of melanoma of the central nervous system (CNS). The clinical and electron microscopy pathology data of nine patients with melanoma surveyed from 1993 to 2017 were analyzed. All the CNS melanomas were confirmed by transmission electron microscopy (TEM), including eight cases of primary melanomas and one case of metastatic melanoma. In this study, four stage II melanosomes were intracranial space-occupying, three of which were malignant melanoma, the other one was melanoma. Among the five stage IV melanosomes, four cases were intraspinal space-occupying, the other one was intracranial space-occupying, and the pathological diagnoses were all melanoma. At present, TEM is an important tool for the diagnosis of CNS melanomas. Malignant melanoma has high malignancy and recurrence rate and poor prognosis, while benign melanoma with relatively low recurrence rate, so we speculate that patients with mainly immature melanosomes are more likely to exhibit recurrence.
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Affiliation(s)
- Qi Zhang
- Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Haibo Zhu
- Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Cuiping Zhang
- Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ying Wang
- Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yanjiao He
- Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Guilin Li
- Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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5
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Guo W, Yin G, Liu H, Duan H, Huang Z, Chen X. Matched analysis of the prognosis of amelanotic and pigmented melanoma in head and neck. Acta Otolaryngol 2020; 140:785-788. [PMID: 32449432 DOI: 10.1080/00016489.2020.1763456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background: The prognosis of mucosal melanoma is poor, and the difference in clinical prognosis between patients with and without pigment needs further study.Aim: To analyze data with head and neck mucosal melanoma, and compare the prognosis of patients with and without pigment.Material and methods: The patients of amelanotic melanoma were matched with pigmented type according to age, sex, stage, location of disease, treatment history, tobacco and alcohol history. The Kaplan-Meier and Cox proportional risk regression model was used for analyzation.Results: 46 patients of amelanotic melanoma and 46 of pigmented type were included in this study. The overall survival rate and progression-free survival rate of patients with pigmented melanoma were higher than in patients with amelanotic melanoma (HR = 0.533, p = .035, 95% CI = 0.296-0.957; HR = 0.530, p = .034, 95% CI = 0.294-0.953, respectively), and the risk of distant metastases in patients with amelanotic melanoma was significantly higher than that in patients with pigmented melanoma (HR = 0.474, p = .046, 95% CI = 0.228-0.987).Conclusions and significance: The prognosis and disease-free survival of amelanotic melanoma is worse than for the pigmented type group. More identifying the differences in clinical characteristics will help to further individualized treatment decisions.
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Affiliation(s)
- Wei Guo
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Gaofei Yin
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hongfei Liu
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Hanyuan Duan
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Zhigang Huang
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiaohong Chen
- Beijing Tongren Hospital, Capital Medical University, Beijing, China
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6
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Freiberger SN, Morand GB, Turko P, Wager U, Dummer R, Hüllner M, Holzmann D, Rupp NJ, Levesque MP. Morpho-Molecular Assessment Indicates New Prognostic Aspects and Personalized Therapeutic Options in Sinonasal Melanoma. Cancers (Basel) 2019; 11:cancers11091329. [PMID: 31500314 PMCID: PMC6770844 DOI: 10.3390/cancers11091329] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/28/2019] [Accepted: 09/04/2019] [Indexed: 12/27/2022] Open
Abstract
Sinonasal melanoma is a rare subtype of melanoma and little is known about its molecular fingerprint. Systemic treatment options are limited, as targetable BRAF mutations are rare compared to cutaneous melanoma. Currently, metastatic sinonasal melanoma is being treated according to the guidelines of cutaneous melanoma. In this study, we investigated the molecular profile of 19 primary sinonasal melanomas, using a novel customized melanoma-specific next generation sequencing (NGS) panel (MelArray) of 190 genes. Results were correlated to histological and clinical features to further characterize this rare, aggressive type of melanoma and screen for prognostic markers and possible treatment options. Molecular profiles encompassed predominantly mutations in NRAS (25%), whereas KIT or BRAF p.V600 mutations were not detected. Tumor mutational burden was overall low. High level of copy number variations (CNVs) were associated with alterations in DNA-repair genes and shorter distant metastasis-free survival (p = 0.005). Monomorphic (vs. pleomorphic) morphology was found to be significantly associated with worse disease-specific survival (p < 0.001), however no correlation between morphology and molecular aberrations was found. A variety of alterations in different pathways were detected, justifying molecular testing and opening potential personalized treatment options in current study or compassionate use settings.
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Affiliation(s)
- Sandra N Freiberger
- Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.
- University of Zurich, 8006 Zurich, Switzerland.
| | - Grégoire B Morand
- University of Zurich, 8006 Zurich, Switzerland.
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, Switzerland.
| | - Patrick Turko
- University of Zurich, 8006 Zurich, Switzerland.
- Department of Dermatology, University Hospital Zurich, 8091 Zurich, Switzerland.
| | - Ulrich Wager
- Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.
- University of Zurich, 8006 Zurich, Switzerland.
| | - Reinhard Dummer
- University of Zurich, 8006 Zurich, Switzerland.
- Department of Dermatology, University Hospital Zurich, 8091 Zurich, Switzerland.
| | - Martin Hüllner
- University of Zurich, 8006 Zurich, Switzerland.
- Department of Nuclear Medicine, University Hospital Zurich, 8091 Zurich, Switzerland.
| | - David Holzmann
- University of Zurich, 8006 Zurich, Switzerland.
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Zurich, 8091 Zurich, Switzerland.
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, 8091 Zurich, Switzerland.
- University of Zurich, 8006 Zurich, Switzerland.
| | - Mitchell P Levesque
- University of Zurich, 8006 Zurich, Switzerland.
- Department of Dermatology, University Hospital Zurich, 8091 Zurich, Switzerland.
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Andreasen S, Kiss K, Mikkelsen LH, Channir HI, Plaschke CC, Melchior LC, Eriksen JG, Wessel I. An update on head and neck cancer: new entities and their histopathology, molecular background, treatment, and outcome. APMIS 2019; 127:240-264. [PMID: 30811708 DOI: 10.1111/apm.12901] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Accepted: 10/08/2018] [Indexed: 12/12/2022]
Abstract
The head and neck region harbor numerous specialized tissues of all lineages giving rise to a plethora of different malignancies. In recent years, new types and subtypes of cancer has been described here due to the recognition of their histological and molecular characteristics. Some have been formally accepted in the most recent classifications from the World Health Organization (WHO) and American Joint Committee on Cancer (AJCC) as distinct diseases due to characteristics in clinical presentation, outcome, and treatment. In particular, this applies to malignancies of the salivary gland, sinonasal tract, and oropharynx. In this overview, we present the most recent developments in the classification, histopathological characteristics, and molecular features of head and neck cancer. The clinical and radiological characteristics, outcome, and treatment options including perspectives for targeted therapies, are discussed.
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Affiliation(s)
- Simon Andreasen
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark.,Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Katalin Kiss
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark
| | - Lauge Hjorth Mikkelsen
- Department of Pathology, Rigshospitalet, Copenhagen, Denmark.,Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark
| | - Hani Ibrahim Channir
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
| | | | | | - Jesper Grau Eriksen
- Department of Experimental Clinical Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - Irene Wessel
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark
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8
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Expressions and clinical significance of HER4 and CD44 in sinonasal mucosal malignant melanoma. Melanoma Res 2019; 28:105-110. [PMID: 29309357 DOI: 10.1097/cmr.0000000000000428] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Sinonasal mucosal malignant melanoma (SNMMM) is a rare disease. The aim of this study was to investigate the expressions of HER4 and CD44 in human SNMMM tissues and their relationship with the clinicopathological features and prognosis of patients. In total, 64 paraffin-embedded samples of SNMMM treated in our hospital from 29 December 1999 to 24 June 2011 were collected. HER4 and CD44 were detected in the tissues of SNMMM by immunohistochemistry. The differences in the HER4 and CD44 expressions in the tissues were evaluated and matched with clinicopathological parameters and the survival rate, respectively. The positive rates of the HER4 and CD44 expressions were 70.3 and 65.6%, respectively; the positive expression of HER4 was correlated with a positive expression of CD44 (P<0.05). The positive expression of HER4 was correlated with the prognosis of SNMMM patients (P<0.05). There was no significant correlation between a positive expression of CD44 and the prognosis of patients (P>0.05). The expressions of HER4 and CD44 were not significantly correlated with sex, age, pigment, tumor site, etc. (P>0.05). Our results further emphasize a correlation between HER4 and CD44 expressions in SNMMM tissues and point out that a positive HER4 expression might be an important factor in valuing the prognosis of patients with SNMMM.
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9
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Zhang Y, Fu X, Qi Y, Gao Q. A study of the clinical characteristics and prognosis of advanced mucosal and cutaneous melanoma in a Chinese population. Immunotherapy 2018; 11:91-99. [PMID: 30511592 DOI: 10.2217/imt-2018-0030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
AIM To investigate the characteristics and prognosis of melanoma in a Chinese population. MATERIALS & METHODS Total of 162 advanced melanoma patients were analyzed retrospectively. Kaplan-Meier method and Log rank test were used for survival analysis. RESULTS The median progression-free survival of mucosal and cutaneous melanoma patients was 13 versus 8 months (p = 0.005), 14 versus 10 months in immunotherapy group (p = 0.022), 6 versus 4 months in chemotherapy group (p = 0.040). Age was an independent risk factor for mucosal melanoma patients. Staging and treatment regimen were independent risk factors for cutaneous melanoma patients. The lungs, liver and brain were most common metastasis locations. CONCLUSION The prognosis of patients with advanced mucosal melanoma is better than cutaneous melanoma in China. There are significant differences between the two subtypes of melanoma.
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Affiliation(s)
- Yong Zhang
- Department of Biotherapy, Affiliated Cancer Hospital of Zhengzhou University, 127 Dong Ming Road, Jinshui District, Zhengzhou, Henan, 450008, PR China
| | - Xiaomin Fu
- Department of Biotherapy, Affiliated Cancer Hospital of Zhengzhou University, 127 Dong Ming Road, Jinshui District, Zhengzhou, Henan, 450008, PR China
| | - Yalong Qi
- Department of Biotherapy, Affiliated Cancer Hospital of Zhengzhou University, 127 Dong Ming Road, Jinshui District, Zhengzhou, Henan, 450008, PR China
| | - Quanli Gao
- Department of Biotherapy, Affiliated Cancer Hospital of Zhengzhou University, 127 Dong Ming Road, Jinshui District, Zhengzhou, Henan, 450008, PR China
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10
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Du J, Huang LL, Xu A, Zhang AL, Kong X, Ding M, Hu W, Guo ZL, Zhong W, Sun SB, Li H, Chen J, Shen Q, Xu LL, Wu HB. Undifferentiated sinonasal malignant melanoma: A case report. Oncol Lett 2018; 16:580-584. [PMID: 29930718 DOI: 10.3892/ol.2018.8662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/12/2018] [Indexed: 12/14/2022] Open
Abstract
Undifferentiated sinonasal malignant melanoma (MM) is a rare type of tumor, which can be easily misdiagnosed. The present study reports a 41-year-old male patient who presented with a 4-day history of epistaxis. Clinical examination and radiological imaging lead to the detection of a mass in the right sinonasal region. Histopathological examination revealed that the mass was composed of malignant epithelioid cells arranged in nests and sheets. These cells displayed a hemangiopericytoma-like pattern with antler-like branching vessels. Immunohistochemical staining revealed that the tumor cells exhibited negative expression of melanocytic markers. This increased the difficulty of distinguishing undifferentiated MM from other malignant tumors located in the sinonasal area, particularly undifferentiated nasopharyngeal carcinoma. The diagnosis of undifferentiated MM was determined by ultrastructures, including the mature melanosomes and premelanosomes, in tumor cells by transmission electron microscopy. The present study suggests that the analysis of cancer stem cell marker and vasculogenic mimicry may be an important auxiliary tool for the diagnosis of MM.
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Affiliation(s)
- Jun Du
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Liang-Liang Huang
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Ao Xu
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - An-Li Zhang
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Xue Kong
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Min Ding
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Wen Hu
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Zhen-Li Guo
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Wen Zhong
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Si-Bai Sun
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Heng Li
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Jie Chen
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Qian Shen
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Lu-Lu Xu
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
| | - Hai-Bo Wu
- Department of Pathology, Anhui Provincial Hospital, Hefei, Anhui 230001, P.R. China
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11
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Caspers CJI, Dronkers EAC, Monserez D, Wieringa MH, Baatenburg de Jong RJ, Hardillo JAU. Adjuvant radiotherapy in sinonasal mucosal melanoma: A retrospective analysis. Clin Otolaryngol 2017; 43:617-623. [PMID: 29150980 DOI: 10.1111/coa.13033] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Evaluation of outcome after curative treatment for sinonasal mucosal melanoma focused on the effect of adjuvant radiotherapy on recurrence and survival. DESIGN Retrospective chart analysis. SETTING Tertiary referral hospital. PARTICIPANTS Fifty-one patients with primary sinonasal mucosal melanoma who underwent surgical resection with curative intention between 1980 and 2016 at Erasmus Medical Center, Rotterdam. MAIN OUTCOME MEASURES Patients were categorised into 2 groups: surgery alone and surgery with adjuvant radiotherapy. Log-rank test was used to compare rates of recurrence and survival between treatment groups. Predictors for treatment modality, recurrence and survival were assessed with multivariate statistical analysis. RESULTS Of all patients, 23.5% developed local recurrence and 47.1% developed distant metastasis. Estimated 5-year disease-free survival was 25.2%, and 5-year overall survival (OS) was 38.1%. Forty-three patients (84.3%) were treated with post-operative radiotherapy. Patients who underwent surgery with adjuvant radiotherapy presented more often with high tumour stage, tumour involving multiple sites and positive margins. Post-operative radiotherapy seemed to be associated with better local control (P = .549). No effect was found on occurrence of distant metastasis and OS. Positive margin status was an independent negative predictor for distant metastasis-free survival and overall survival. CONCLUSIONS Our treatment outcomes are consistent with literature. Post-operative radiotherapy seems to be associated with improved local control despite advanced disease and positive margin status in this treatment group.
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Affiliation(s)
- C J I Caspers
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center (EMC), Rotterdam, The Netherlands
| | - E A C Dronkers
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center (EMC), Rotterdam, The Netherlands
| | - D Monserez
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center (EMC), Rotterdam, The Netherlands
| | - M H Wieringa
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center (EMC), Rotterdam, The Netherlands
| | - R J Baatenburg de Jong
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center (EMC), Rotterdam, The Netherlands
| | - J A U Hardillo
- Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus University Medical Center (EMC), Rotterdam, The Netherlands
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12
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Nagarajan P, Curry JL, Ning J, Piao J, Torres-Cabala CA, Aung PP, Ivan D, Ross MI, Levenback CF, Frumovitz M, Gershenwald JE, Davies MA, Malpica A, Prieto VG, Tetzlaff MT. Tumor Thickness and Mitotic Rate Robustly Predict Melanoma-Specific Survival in Patients with Primary Vulvar Melanoma: A Retrospective Review of 100 Cases. Clin Cancer Res 2016; 23:2093-2104. [PMID: 27864417 DOI: 10.1158/1078-0432.ccr-16-2126] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/27/2016] [Accepted: 11/11/2016] [Indexed: 11/16/2022]
Abstract
Purpose: Primary vulvar melanoma (PVM) is the second most common vulvar malignancy. Despite their distinct anatomic site and unique molecular-genetic alterations, PVMs are staged according to the American Joint Committee on Cancer (AJCC) guidelines for primary cutaneous melanomas (PCM). However, whether parameters derived for PCM also apply to PVM remain a critical yet largely unexplored clinical question. The objective of this study was to determine the parameters predictive of survival in PVM.Experimental Design: We retrospectively reviewed 100 patients with PVM and determined associations between clinical and histopathologic parameters and disease-specific survival (DSS) and overall survival (OS).Results: Univariate Cox regression analysis demonstrated older age (>56 years), greater tumor thickness, higher dermal mitotic rate, ulceration, lymphovascular invasion, perineural invasion, microscopic satellitosis, and absence of precursor nevus associated with decreased OS. Furthermore, age, midline, and/or multifocal involvement, greater tumor thickness, higher dermal mitotic rate, ulceration, lack of regression, lymphovascular invasion, perineural invasion, and microscopic satellitosis associated with decreased DSS. Multivariate analysis demonstrated tumor thickness, dermal mitotic rate, lymphovascular invasion, microscopic satellitosis, and absence of precursor nevus independently predicted shorter OS. Only tumor thickness and increased dermal mitotic rate (≥2/mm2) independently predicted reduced DSS. In comparison with the AJCC T-category, a novel, bivariate T-category based only on tumor thickness and dermal mitotic rate robustly predicted OS and DSS in our patient cohort.Conclusions: In the largest single institutional study of PVM, we demonstrate a combination of tumor thickness and mitotic rate comprise a simple but robust T-category to direct staging and prognosis. Clin Cancer Res; 23(8); 2093-104. ©2016 AACR.
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Affiliation(s)
| | - Jonathan L Curry
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jing Ning
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jin Piao
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Carlos A Torres-Cabala
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Phyu P Aung
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Doina Ivan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Merrick I Ross
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Charles F Levenback
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael Frumovitz
- Department of Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael A Davies
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Anais Malpica
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Victor G Prieto
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston, Texas.,Department of Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael T Tetzlaff
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas. .,Department of Translational and Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
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