Metastases of melanoma in lymph nodes with unknown primary site
https://doi.org/10.33667/2078-5631-2023-10-30-35
Abstract
Introduction. Melanoma is a malignant tumor that develops from melanocytes, has a high malignant potential and is characterized by early and aggressive metastasis. Just like with many other malignant neoplasms, melanoma can be clinically manifested by metastases in the absence of a primary focus. In the world and in Russia, there has been a steady increase in the incidence of melanoma over the past thirty years. Identifiation of the primary focus with an established diagnosis of metastases of a malignant tumor during life occurs no more than 25 % of cases. Even at autopsy, the primary focus is found on average in 15–20 % of patients, subject to a complete examination of the patient during his lifetime. The prognostic value of identifying the primary focus in melanoma remains unclear.
Objective. To improve the diagnosis and treatment of patients with melanoma metastases without an identifid primary focus by assessing the signifiance of various factors, including the fact that the primary tumor was detected.
Materials and methods. Since 2005 to 2019 at the National Medical Research Centre of Oncology n. a. N. N. Blokhin (Moscow, Russia) 196 patients with metastases of melanoma in the lymph nodes were observed and treated. Patient medical history were analyzed retrospectively and prospectively. All patients were followed up on an ambulatory after treatment. The inflence of the main clinical and morphological characteristics on the survival rates of patients was assessed. Patients with a morphologically confimed diagnosis of melanoma metastases in
About the Authors
M. A. KrylovetskayaRussian Federation
Krylovetskaya Maria A., endoscopist at Endoscopy Dept of Research Institute of Clinical Oncology
Moscow
I. G. Komarov
Russian Federation
Komarov Igor G., DM Sci (habil.), professor, leading researcher1 , professor at Dept of Oncology and Palliative Medicine n. a. A. I. Savitsky
Moscow
M. I. Komarov
Russian Federation
Komarov Maxim I., PhD Med, researcher at Oncology Dept of Surgical Methods of Treatment No. 4 of Research Institute of Clinical Oncology
Moscow
O. A. Gusarova
Russian Federation
Gusarova Olga A., resident endoscopist at Endoscopy Dept of Research Institute of Clinical Oncology
Moscow
O. A. Malikhova
Russian Federation
Malikhova Olga A., DM Sci (habil.), endoscopist, head of Endoscopy Dept of Research Institute of Clinical Oncolog , professor at Dept of Oncology and Palliative Medicine n. a. A. I. Savitsky
Moscow
References
1. Benderra M-A., Ilié M., Hofman P. et al. Standard of care of carcinomas on cancer of unknown primary site in 2016. Bulletin du Cancer. 2016; 103 (7): 697–705. DOI:10.1016/j.bulcan.2016.05.003.
2. Pavlidis N., Pentheroudakis G. Cancer of unknown primary site: 20 questions to be answered. Ann Oncol. 2010; 21 (7): 303–307. DOI: 10.1186/s12885–017–3083–1.
3. Вагнер Р. И., Анисимов В. В., Барчук А. С. Меланома кожи. Часть 1. Наука. СПб.: 1995; С. 151.
4. Vagner R. I., Anisimov V. V., Barchuk A. S. Skin melanoma. Part 1. Science. St. Petersburg: 1995; P. 151.
5. MacKie R. M. Incidence, risk factors and prevention of melanoma. European Journal of Cancer. 1998; 34: 53–56.
6. Balch C.M, Buzaid A. C., Soong S. J. et al. Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma. J. Clin. Oncol. 2001; 19: 3635–3648.
7. Balch С. М., Soong S. J., Shaw H. M. et al. An analysis of prognostic factors in 8.500
8. patients with cutaneous melanoma. С. М. Balch, A. N. Houghton, G. W. Milton et al., eds. Cutaneous Melanoma, 2nd ed. Philadelphia: J. B. Lippincott, 1992; 165.
9. Nambisan R. N. Early metastatic patterns and survival in malignant melanoma. J. Surg. Oncol. 1987; 34 (4): 248–252.
10. Анисимов В. В. Содержание понятия «местный рецидив» после хирургического лечения злокачественной меланомы кожи. Вопросы онкологии. 1985. Т. 31. № 1. С. 32–37.
11. Anisimov V. V. The content of the concept of ‘local recurrence’ after surgical treatment of malignant melanoma of the skin. Issues of oncology. 1985. V. 31. No. 1. P. 32–37.
12. Фрадкин С. З., Залуцкий И. В. Меланома кожи. Минск: Беларусь, 2000. С. 221.
13. Fradkin S. Z., Zalutsky I. V. Skin melanoma. Minsk: Belarus, 2000. P. 221.
14. Трапезников H. H., Рабен A. C., Яворский В. В., Титинер Г. Б. Пигментные невусы и новообразования кожи. М.: Медицина, 1976. С. 177.
15. Trapeznikov H. H., Raben A. S., Yavorsky V. V., Titiner G. B. Pigmented nevi and skin neoplasms. M.: Medicine, 1976. P. 177.
16. Веснин А. Г., Филимонов С. И., Семенов И. И., Тришкин Б. А. Рентгенологическая и ультразвуковая диагностика меланобластом кожи и ее лимфогенных и гематогенных метастазов. Актуальные вопросы диагностики и лечения. Ленинград. 1987. С. 57–72.
17. Vesnin A. G., Filimonov S. I., Semenov I. I., Trishkin B. A. X-ray and ultrasound diagnostics of skin melanoblastomas and its lymphogenous and hematogenous metastases. Topical issues of diagnosis and treatment. Leningrad. 1987, pp. 57–72.
18. Березкин Д. П., Айрапетян М. Х., Барсегян B. C. Прогностические факторы, наиболее влияющие на выживаемость больных меланомой кожи. Клиника и лечение меланом кожи: Тез. всесоюз. симпозиума. Л., 1990. С. 7–9.
19. Berezkin D. P., Hayrapetyan M. Kh., Barseghyan B. C. Prognostic factors most inflencing the survival of patients with skin melanoma. Clinic and treatment of melanoma of the skin: Abstracts of all-union symposium. L., 1990. P. 7–9.
20. Reintgen D, Balch CM, Kirkwood J, et al. Recent advances in the care of the patient with malignant melanoma. Ann Surg 1997; 225: 1–14.
21. Löfflr H, Neben K, Krämer A. CUP-Syndrom. Epidemiologie und Pathogenese. [Cancer of unknown primary. Epidemiology and pathogenesis]. Radiologe. 2014; 54 (2): 107–11. German. DOI: 10.1007/s00117–013–2544-z.
22. Löfflr H, Pfarr N, Kriegsmann M, Endris V, Hielscher T, Lohneis P, Folprecht G, Stenzinger A, Dietel M, Weichert W, Krämer A. Molecular driver alterations and their clinical relevance in cancer of unknown primary site. Oncotarget. 2016, 12; 7 (28): 44322–44329. DOI: 10.18632/oncotarget.10035.
Review
For citations:
Krylovetskaya M.A., Komarov I.G., Komarov M.I., Gusarova O.A., Malikhova O.A. Metastases of melanoma in lymph nodes with unknown primary site. Medical alphabet. 2023;(10):30-35. (In Russ.) https://doi.org/10.33667/2078-5631-2023-10-30-35