Noncutaneous Melanoma Have Distinct Features from Each Other and Cutaneous Melanoma

Taş, Faruk; Keskın, Serkan; Karadeniz, Ahmet; Dağoğlu, Nergiz; Şen, Fatma; Kılıç, Leyla; Yıldız, İbrahim

doi:10.1159/000334863

Cited by 50 publications

(43 citation statements)

References 54 publications

(35 reference statements)

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“…By the time the tumor is diagnosed, the malignant cells often have invaded to a deeper level and are thus at a higher stage than the average cutaneous melanoma [6,9,22]. The 5-year survival rate varies between 15 and 20 % [4,6,23], with older age, extent of the primary tumor, poor accessibility for resection, and non-pigmented lesions contributing to a poorer outcome [19,24]. Lymph node involvement tends to have a direct negative effect on prognosis in mucosal melanomas [24].…”

Section: Discussionmentioning

confidence: 99%

“…The 5-year survival rate varies between 15 and 20 % [4,6,23], with older age, extent of the primary tumor, poor accessibility for resection, and non-pigmented lesions contributing to a poorer outcome [19,24]. Lymph node involvement tends to have a direct negative effect on prognosis in mucosal melanomas [24]. Lymph node metastases have been reported in 25 % of the patients diagnosed with melanoma of the oral cavity [19].…”

Section: Discussionmentioning

confidence: 99%

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Melanoma of the Oral Cavity: an Analysis of 46 New Cases with Emphasis on Clinical and Histopathologic Characteristics

Smith

Bhattacharyya

Cohen

et al. 2016

Head and Neck Pathol

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Melanoma of the oral cavity is a rare malignancy that carries a poor prognosis. We identified 46 new cases of both primary and metastatic melanoma to the oral cavity. Following IRB approval, these cases were obtained from the Oral Pathology Biopsy Service archives of the UF College of Dentistry (1994Dentistry ( -2014, the UK College of Dentistry (1997Dentistry ( -2015, and the UM Medical Center . All slides were reviewed. The location, age, race, gender, clinical impression, duration of lesion, histopathologic diagnosis, and histopathologic features were recorded. Cases from the facial skin and those with an ambiguous diagnosis were excluded. Forty-six cases fulfilled the inclusion criteria with 32 primary cases, 11 known metastases, and 3 cases where metastasis could not be excluded. The primary cases included a total of 20 females and 12 males with an average age of 66.7 (range 27-95), and the majority (80 %) of the patients were Caucasian when race was known. Twenty-two of the 32 primary cases (68.8 %) were located in the maxillary mucosa, 5 in the mandibular mucosa or bone, and 5 in other locations. The clinicians' impressions varied from benign fibrous growths to high grade malignancies. The histopathology varied widely among the cases, however two cell types predominated (often in combination): epithelioid cells (50.0 %) and spindle cells (50.0 %). Only 53.1 % demonstrated melanin pigmentation. Oral melanoma remains one of the most diverse clinical and histopathologic diagnoses. Better understanding of this neoplasm may promote earlier diagnosis and may lead to improved outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Melanoma of the Oral Cavity: an Analysis of 46 New Cases with Emphasis on Clinical and Histopathologic Characteristics

Smith

Bhattacharyya

Cohen

et al. 2016

Head and Neck Pathol

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“…45 The remaining 10% are composed of acral lentiginous melanoma (most commonly found on the palms of the hands and soles of the feet) and noncutaneous melanomas such as ocular and mucosal melanoma. 46 Because of their location and rarity, noncutaneous melanomas often remain undetected until they reach an advanced stage, at which time treatment options are limited and outcomes are particularly poor. Evidence of the efficacy and safety of ipilimumab in patients with these rare melanoma subtypes is limited; however, preliminary data from expanded access programs (EAPs) or single-institution studies provide some indication of activity.…”

Section: ■■ Use Of Therapy In Specific Subpopulationsmentioning

confidence: 99%

Current and Future Roles of Targeted Therapy and Immunotherapy in Advanced Melanoma

Olszanski¹

2014

JMCP

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Skin cancer is the most common form of cancer in the United States.1 Most patients develop nonmelanoma skin cancer, where surgical excision of the primary lesion remains effective for early disease, and survival rate is high. Although melanoma accounts for less than 5% of cases of skin cancer, it accounts for most (75%) skin cancer-related deaths. It is estimated that, in 2014, almost 76,100 men and women in the United States will be diagnosed with invasive melanoma of the skin, and close to 9,710 people will die from the disease. Furthermore, melanoma is the most common form of cancer for young adults aged 25 to 29 years and the second most common form of cancer for young people aged 15 to 29 years.2 Given the prevalence of melanoma in young individuals, it accounts for 1 of the 10 leading causes of years of life lost. 3 The overall 5-year survival rate from diagnosis for patients whose melanoma is detected early, before the tumor has spread to regional lymph nodes or other organs, is about 98% in the United States, falling to 62% when the disease reaches

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“…7 Mucosal melanomas primarily occur in the head and neck region (eg, nasal and oral cavities), followed by the GI tract (anorectum) and female genital tract (vulva and vagina). 8,9 Accordingly, they occur at a higher incidence in females than in males. 10 Although mucosal melanomas are rare in white populations, accounting for 2% or less of all melanomas, 7,10 the incidence has been reported to be up to 23% in Chinese populations.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Nivolumab Alone or in Combination With Ipilimumab in Patients With Mucosal Melanoma: A Pooled Analysis

D’Angelo

Larkin

Sosman

et al. 2017

JCO

469

341

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Mucosal melanoma is an aggressive malignancy with a poor response to conventional therapies. The efficacy and safety of nivolumab (a programmed death-1 checkpoint inhibitor), alone or combined with ipilimumab (a cytotoxic T-lymphocyte antigen-4 checkpoint inhibitor), have not been reported in this rare melanoma subtype. Patients and MethodsData were pooled from 889 patients who received nivolumab monotherapy in clinical studies, including phase III trials; 86 (10%) had mucosal melanoma and 665 (75%) had cutaneous melanoma. Data were also pooled for patients who received nivolumab combined with ipilimumab (n = 35, mucosal melanoma; n = 326, cutaneous melanoma). ResultsAmong patients who received nivolumab monotherapy, median progression-free survival was 3.0 months (95% CI, 2.2 to 5.4 months) and 6.2 months (95% CI, 5.1 to 7.5 months) for mucosal and cutaneous melanoma, with objective response rates of 23.3% (95% CI, 14.8% to 33.6%) and 40.9% (95% CI, 37.1% to 44.7%), respectively. Median progression-free survival in patients treated with nivolumab combined with ipilimumab was 5.9 months (95% CI, 2.8 months to not reached) and 11.7 months (95% CI, 8.9 to 16.7 months) for mucosal and cutaneous melanoma, with objective response rates of 37.1% (95% CI, 21.5% to 55.1%) and 60.4% (95% CI, 54.9% to 65.8%), respectively. For mucosal and cutaneous melanoma, respectively, the incidence of grade 3 or 4 treatment-related adverse events was 8.1% and 12.5% for nivolumab monotherapy and 40.0% and 54.9% for combination therapy. ConclusionTo our knowledge, this is the largest analysis of data for anti-programmed death-1 therapy in mucosal melanoma to date. Nivolumab combined with ipilimumab seemed to have greater efficacy than either agent alone, and although the activity was lower in mucosal melanoma, the safety profile was similar between subtypes.J Clin Oncol 35:226-235.

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Noncutaneous Melanoma Have Distinct Features from Each Other and Cutaneous Melanoma

Cited by 50 publications

References 54 publications

Melanoma of the Oral Cavity: an Analysis of 46 New Cases with Emphasis on Clinical and Histopathologic Characteristics

Melanoma of the Oral Cavity: an Analysis of 46 New Cases with Emphasis on Clinical and Histopathologic Characteristics

Current and Future Roles of Targeted Therapy and Immunotherapy in Advanced Melanoma

Efficacy and Safety of Nivolumab Alone or in Combination With Ipilimumab in Patients With Mucosal Melanoma: A Pooled Analysis

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