Oncology Medical News about stage IV melanoma;improved survival

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Improved survival for stage iv melanoma from an unknown primary site
Journal of Clinical Oncology, 05/20/09

Lee CC et al. - In a study to determine whether a survival advantage for nodal metastasis of melanoma from an unknown primary (MUP) vs melanoma from a known primary (MKP) would extend to MUP pts with distant (stage IV) metastasis, it was shown that the survival advantage also applies to pts with stage IV MUP. The mechanism responsible for this improved survival may provide clues for more effective treatment of stage IV melanoma and warrants further investigation. Improved results for MUP suggest that these pts deserve aggressive therapy.

Methods

Prospectively acquired data for 2247 pts diagnosed with American Joint Committee on Cancer stage IV melanoma were reviewed.
Cox regression analysis in a multivariate model identified prognostic factors significant for survival.
MUP and MKP patients were then matched by significant covariates.
Overall survival (OS) was estimated by Kaplan-Meier method and compared by log-rank analysis.

Results

There were 1849 MKP and 398 MUP pts.
Multivariate analysis of pts with complete data sets identified known/unknown primary and 5 other significant covariates: age, sex, site of metastasis, number of different metastatic sites, and decade of diagnosis.
Prognostic matching yielded 392 MUP-MKP pairs.
Median OS and 5-yr OS rate were significantly greater for MUP pts than for all matched MKP pts or for MKP pts matched by M1 category (for M1b and M1c) or number of metastatic sites.

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