Metastatic melanomas of unknown primary show better prognosis than those of known primary: A systematic review and meta-analysis of observational studies - 13/12/14
Abstract |
Background |
Melanoma of unknown primary (MUP) is a condition of metastatic melanoma without a primary lesion.
Objective |
We sought to identify the prognosis of MUP compared with melanoma of known primary (MKP).
Methods |
We searched for observational studies containing at least 10 patients with MUP from MEDLINE and EMBASE from inception to December 22, 2012. The outcomes of interest were overall and disease-free survival; meta-analyses of hazard ratio stratified by stage using a random effects model were performed. In addition, second systematic review identified risk factors influencing the survival of patients with MUP.
Results |
Eighteen studies including 2084 patients with MUP and 5894 with MKP were included. MUP had a better overall survival compared with MKP in stage III (15 studies; hazard ratio 0.83, 95% confidence interval 0.73-0.96, P = .010) and stage IV (6 studies; hazard ratio 0.85, 95% confidence interval 0.75-0.96, P = .008). Secondly, 22 studies including 3312 patients with MUP were reviewed, and increased stage and old age were the risk factors in patients with MUP.
Limitations |
Diverse observational studies were reviewed, and selection and reporting biases are possible.
Conclusions |
The current meta-analyses suggest better survival outcomes in patients with MUP than those in patients with MKP with the same corresponding tumor stage.
Le texte complet de cet article est disponible en PDF.Key words : malignant melanoma, melanoma, melanoma, unknown primary, meta-analysis, prognosis, systematic review
Abbreviations used : CI, DFS, HR, MKP, MUP, OS
Plan
| Drs Bae and Choi contributed equally to this work. |
|
| This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF-2013R1A2A2A04015894). |
|
| Conflicts of interest: None declared. |
Vol 72 - N° 1
P. 59-70 - janvier 2015 Retour au numéro
Article précédent
- Outcome of patients with de novo versus nevus-associated melanoma
- William M. Lin, Su Luo, Alona Muzikansky, Alice Z.C. Lobo, Kenneth K. Tanabe, Arthur J. Sober, A. Benedict Cosimi, Hensin Tsao, Lyn M. Duncan
- Acral lentiginous melanoma: Who benefits from sentinel lymph node biopsy?
- Takamichi Ito, Maiko Wada, Konosuke Nagae, Misa Nakano-Nakamura, Takeshi Nakahara, Akihito Hagihara, Masutaka Furue, Hiroshi Uchi
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?