Malignant melanoma in Taiwan: a prognostic study of 181 cases

Chang, John Wen‐Cheng; Yeh, Kun‐Yun; Wang, Cheng‐Hsu; Yang, Tse-Yen; Chiang, Hseui-Fong; Wei, Fu‐Chan; Kuo, Tseng‐Tong; Yang, Chih-Hsun

doi:10.1097/00008390-200412000-00016

Cited by 114 publications

(118 citation statements)

References 12 publications

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“…Our study revealed that SSM was lower and ALM was higher compared to western countries. However, our ALM frequency was similar to another study from Turkey but it was not as high as in reported studies from Asian countries (Chang et al, 2004;Tas et al, 2006;Lee et al, 2012). When the histological subtypes which were categorized as ALM and nonALM, it was not associated with DFS and OS for patients with thick melanoma (Fujisawa et al, 2012).…”

Section: Discussionsupporting

confidence: 89%

See 1 more Smart Citation

A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey

Gamsızkan¹,

Yılmaz²,

Büyükbabanı³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: We defined melanoma distribution in a large series of Turkish patients and evaluated the prognostic parameters of melanomas. Materials and Methods: A total of 1574 patients' data was retrospectively collected at 18 centers in Turkey. Demographic characteristics were questioned and noted. Prognostic parametres were evaluated based on sentinel lymph node involvement. Results: Mean age was 56.7 (4-99) years. While 844 (53.6%) cases were male, 730 (46.4%) cases were female. One thousand four hundred forty-seven (92%) cases were invasive melanoma and 127 (8%) cases were in-situ melanoma. The most common histopathological form was the superficial spreading melanoma (SSM) which was found in 549 patients (37.9%). It was followed by nodular melanoma in 379 (26.2%), acral lentiginous melanoma (ALM) in 191 (13.2%) and lentigo maligna melanoma in 132 (9.1%), respectively. On univariate analysis, lymphovascular invasion (p<0.001), tumor thickness (p<0.001), histopathological subtype (p<0.001), Clark level (p=0.001), ulceration (p<0.001), ≥6/mm 2 mitosis (p=0.005), satellite formation (p=0.001) and gender (p=0.03) were found to be associated with sentinel lymph node positivity. Regression was associated with sentinel lymph node negativity (p=0.017). According to multivariate analysis, lymphovascular invasion and tumor thickness were significant independent predictive factors of SLN positivity. Patient age, tumor localization, precursor lesions, lymphocytic infiltration and neurotropism were not related with sentinel lymph node involvement. Conclusions: In this retrospective analysis, it was found that the prevalence of SSM is at a lower rate while the prevalence of ALM is at a higher rate when compared to western countries. According to Breslow index; most of the melanoma lesions' thickness were greater than 2 mm, corresponding Clark IV. Vascular invasion and tumor thickness are the most important factors for sentinel lymph node involvement.

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Section: Discussionsupporting

confidence: 89%

“…Some studies from Asia have reported that ALM is the most common form in MM and its frequency is about 50%. (Chang et al, 2004;Lee et al, 2012). The most common histopathological form in our study was SSM (37.9%), followed by NM (26.2%) and ALM (13.2%).…”

Section: Discussionmentioning

confidence: 99%

A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey

Gamsızkan¹,

Yılmaz²,

Büyükbabanı³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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“…The mean age in other studies is slightly lower than our 65.3 years (from 55.9 [13] to 61 years [14]). The proportion of ALM of all melanoma in other studies ranges from 41.8% [15] to 85.9% [9], therefore the reported 8/10 "likely ALM" reported here is within the reported range of the region.…”

Section: Discussioncontrasting

confidence: 79%

“…Nevertheless, assuming a best-case scenario for all other patients, we have at best an 8/ 10 patient 6-month survival in this series, compared with an overall 80.3% 5-year survival rate of ALM in a study from the USA. We note, however, 5-year survival rates from studies in Asian countries are typically 41%−49% [9,14,15]. This is likely to be a direct result of the late presentation and late stage of the patients in this series.…”

Section: Acral Melanoma In Cambodiamentioning

confidence: 70%

Clinical report. Acral melanoma in Cambodia: challenges associated with a rare and aggressive disease encountered in a developing country setting

et al. 2014

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Background: Melanoma is a highly malignant skin cancer. Acral lentiginous melanoma (ALM) is most common among Asians. The prevalence of ALM among melanoma cases in Cambodian is not known. Objective: To describe the prevalence of ALM among cases of melanoma and the stage of disease at presentation to the health facilities and health providers. Method: Electronic clinical records were obtained from Children’s Surgical Centre (CSC) database between January 2002 and April 2014. Types and stages melanoma at presentation were documented. Result: A total of 10 out of 26 melanoma patients had ALM. Their average age at diagnosis was 65.3 years. Most primary lesions were located on the plantar or lateral surfaces of the foot. Most histopathological descriptions were consistent with ALM. Seventy percent had lymph node metastases. Conclusion: A high proportion of ALM was found associated with trauma as a potential risk factor. Most frequency presented at a late stage of disease. Providers must be made aware of the disease and render appropriate management early for good outcome.

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“…Despite comprising only 2%-10% of all melanomas, acral melanoma is the most frequent subtype in patients of African, Middle Eastern, and Asian descent [9][10][11]. Acral melanoma confers a worse overall prognosis compared with cutaneous melanomas in Western series (largely in the preipilimumab/BRAF inhibitor era), although this negative effect is not clear in Asian studies [9,[12][13][14][15][16].The spectrum and frequency of genetic alterations in this subtype is distinct from cutaneous melanoma; KIT mutations occur more commonly (15%-20% vs. 1%), BRAF V600 mutations arise less often (15% vs. 45%-50%), and NRAS mutations are found at similar incidence (15%-20%) [17,18]. Accordingly, no genotype-specific treatments are available for many patients, thus making ipilimumab and other immune therapies the principal therapeutic strategy for patients with advanced acral melanoma.…”

Section: Introductionmentioning

confidence: 99%

Clinical Activity of Ipilimumab in Acral Melanoma: A Retrospective Review

Johnson¹,

Peng

Abramson³

et al. 2015

The Oncologist

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Background. Ipilimumab improves overall survival (OS) in advanced melanoma. Acral melanoma is an uncommon clinical subtype of this disease associated with poor prognosis. The clinical activity of ipilimumab has not been well‐defined in advanced acral melanoma. Methods. We retrospectively reviewed the demographics, treatment history, and clinical outcomes for all patients with acral melanoma treated with ipilimumab from two academic centers between February 2006 and June 2013. Using Cox proportional hazards models, we assessed for factors that correlated with OS. Results. A total of 35 patients with acral melanoma received ipilimumab. Melanomas arose on volar surfaces (n = 28) and subungual sites (n = 7); stage M1c disease was present in 54%, and 45% had elevated serum lactate dehydrogenase (LDH). Best response by RECIST 1.1 criteria was complete response in 1 patient, partial response in 3, and stable disease (SD) in 4 for an objective response rate (ORR) of 11.4% and a clinical benefit rate (ORR + SD) at 24 weeks of 22.9%. Median progression‐free survival was 2.5 months (95% confidence interval [CI]: 2.3–2.7 months); median OS was 16.7 months (95% CI: 10.9–22.5 months). Normal LDH and absolute lymphocyte count ≥1,000 at 7 weeks predicted longer OS. Immune‐related adverse events (irAEs) were noted in 16 patients including 7 with grade 3/4 irAEs (20%). Conclusion. Ipilimumab is clinically active in acral melanoma with similar ORR and OS compared with unselected melanoma populations. Ipilimumab remains a viable therapeutic option for patients with advanced acral melanoma. Implications for Practice: Ipilimumab is a commonly used immune therapy that improves survival in metastatic melanoma. The clinical activity of ipilimumab in certain rare melanoma subtypes, such as uveal or mucosal melanomas, is suboptimal. Acral melanoma is another unusual subtype of this disease that arises on the palms, soles, and nailbeds. In this study of 35 patients with acral melanoma from 2 centers, ipilimumab was found to have activity that appears equivalent to unselected melanoma (response rate of 11.4%, median overall survival of 16.7 months). Ipilimumab remains a viable treatment option for this melanoma subpopulation.

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Malignant melanoma in Taiwan: a prognostic study of 181 cases

Cited by 114 publications

References 12 publications

A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey

A Retrospective Multicenter Evaluation of Cutaneous Melanomas in Turkey

Clinical report. Acral melanoma in Cambodia: challenges associated with a rare and aggressive disease encountered in a developing country setting

Clinical Activity of Ipilimumab in Acral Melanoma: A Retrospective Review

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