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Improved survival for stage IV melanoma from an unknown primary site
Journal of Clinical Oncology, 07/20/09
Lee CC et al. - The survival advantage previously reported for patients with stage III melanoma from an unknown primar (MUP) also applies to patients with stage IV MUP. The mechanism responsible for this improved survival may provide clues for more effective treatment of stage IV melanoma and therefore warrants further investigation.
Methods- Study investigates the survival benefit in MUP pts with distant (stage IV) metastasis as reported before for stage III pts
- Acquired data for 2,247 pts was reviewed prospectively
- Cox regression analysis in a multivariate model identified prognostic factors significant for survival
- MUP and MKP (melanoma from a known primary) pts were then matched by significant covariates
- Overall survival (OS) was estimated by Kaplan-Meier method and compared by log-rank analysis
- There were 1,849 MKP and 398 MUP pts
- Known/unknown primary and 5 other significant covariates: age, sex, site of metastasis, number of different metastatic sites, and decade of diagnosis were identified
- Prognostic matching yielded 392 MUP-MKP pairs
- Median OS and 5-yr OS rate were greater for MUP pts than for all matched MKP pts or for MKP pts matched by M1 category or number of metastatic sites
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