原发灶不明和已知的黑色素瘤患者的生存和治疗反应：单中心回顾性分析。

Survival and therapeutic response in patients with melanoma of unknown and known primary: a single-centre retrospective analysis.

机构信息

Department of Dermatology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland.

Department of Dermatology, University Hospital Zurich, University of Zurich, Rämistrasse 100, 8091 Zurich, Switzerland, Department of Dermatology and Allergology, Paracelsus Medical University, Müllner Hauptstrasse 48, 5020 Salzburg, Austria.

出版信息

Eur J Dermatol. 2020 Dec 1;30(6):699-709. doi: 10.1684/ejd.2020.3929.

DOI:10.1684/ejd.2020.3929

PMID:33459260

Abstract

BACKGROUND

The survival of patients with melanoma of unknown primary (MUP) is proposed to be more favourable than that for melanoma of known primary (MKP). This may be due to an enhanced initial immune response in patients with MUP, which could also affect the efficacy of immunotherapy in advanced disease.

OBJECTIVES

The present study compared therapeutic outcome and survival in Stage III and IV MUP and MKP.

RESULTS

Medical records of 67 MUP and 536 MKP patients were reviewed. Median overall survival (OS) in Stage III patients was 77 months versus 54 months in patients with MUP and MKP, respectively (p = 0.11). Median OS was prolonged in MUP patients receiving adjuvant first-line ipilimumab (p = 0.14). In contrast, OS tended to be more favourable in patients with MKP after palliative first-line ipilimumab treatment (p = 0.16). Yet, no statistically significant differences in OS were detected between the groups. Moreover, survival after anti-PD-1-antibody treatment was similar in patients with MUP and MKP.

CONCLUSION

Overall, we observed similar survival outcomes after immunotherapy in patients with MUP and MKP. These findings provide no evidence of difference in responsiveness to immunotherapy between patients with MUP and MKP.

摘要

背景

据报道，原发灶不明黑色素瘤（MUP）患者的生存率优于已知原发灶黑色素瘤（MKP）患者。这可能是由于 MUP 患者初始免疫反应增强，这也可能影响晚期疾病免疫治疗的疗效。

目的

本研究比较了 III 期和 IV 期 MUP 和 MKP 的治疗效果和生存情况。

结果

回顾了 67 例 MUP 和 536 例 MKP 患者的病历。III 期患者的中位总生存期（OS）分别为 MUP 患者 77 个月和 MKP 患者 54 个月（p=0.11）。MUP 患者接受辅助一线伊匹单抗治疗的中位 OS 延长（p=0.14）。相比之下，MKP 患者接受姑息一线伊匹单抗治疗后 OS 更有利（p=0.16）。然而，两组间 OS 无统计学差异。此外，MUP 和 MKP 患者接受抗 PD-1 抗体治疗后的生存情况相似。