Department of Medicine, Division of Hematology/Oncology, Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Hillman Cancer Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
Cancer. 2022 Jun 1;128(11):2098-2106. doi: 10.1002/cncr.34169. Epub 2022 Mar 23.
Given equivocal results related to overall survival (OS) for patients with multiple primary melanomas (MPMs) compared with those with single primary melanomas (SPMs) in previous reports, the authors sought to determine whether OS differs between these 2 cohorts in their center using their UPCI-96-99 database. Secondary aims were to assess the differences in recurrence-free survival (RFS). In a subset of patients, transcriptomic profiling of peripheral blood mononuclear cells (PBMCs) was performed to assess disease-associated genes of interest.
This retrospective case-controlled study included patients with MPMs and age-, sex-, and stage-matched controls with SPMs at a 1:1 ratio. Cox regression models were used to evaluate the effect of the presence of MPMs on death and recurrence. NanoString PanCancer Immune Profiling was used to assess peripheral blood immune status in patients.
In total, 320 patients were evaluated. The mean patient age was 47 years; 43.8% were male. Patients with MPMs had worse RFS and OS (P = .023 and P = .0019, respectively). The presence of MPMs was associated with an increased risk of death (hazard ratio [HR], 4.52, P = .0006), and increased risk of disease recurrence (HR, 2.17; P = .004) after adjusting for age, sex, and stage. The degree of tumor-infiltrating lymphocytes (TILs) was different between the first melanoma of MPMs and SPMs. Expression of CXCL6 and FOXJ1 was increased in PBMCs isolated from patients with MPMs.
Patients with MPMs had worse RFS and OS compared with patients with SPMs. Immunologic differences were also observed, including TIL content and expression of CXCL6/FOXJ1 in PBMCs of patients with MPMs, which warrant further investigation.
既往报道显示，与单发黑色素瘤（SPM）患者相比，多发黑色素瘤（MPM）患者的总生存（OS）结果存在争议。因此，作者使用 UPCI-96-99 数据库，旨在确定其中心的这两组患者的 OS 是否存在差异。次要目标是评估无复发生存（RFS）的差异。在一部分患者中，对其外周血单核细胞（PBMC）进行了转录组谱分析，以评估与疾病相关的感兴趣基因。
本回顾性病例对照研究纳入了 MPM 患者和年龄、性别、分期相匹配的 SPM 患者，匹配比例为 1:1。采用 Cox 回归模型评估 MPM 存在对死亡和复发的影响。采用 NanoString PanCancer Immune Profiling 评估患者外周血免疫状态。
共评估了 320 例患者，患者的平均年龄为 47 岁，43.8%为男性。MPM 患者的 RFS 和 OS 更差（P=.023 和 P=.0019）。校正年龄、性别和分期后，MPM 的存在与死亡风险增加（风险比 [HR]，4.52，P=.0006）和疾病复发风险增加（HR，2.17；P=.004）相关。MPM 中第一个黑色素瘤的肿瘤浸润淋巴细胞（TIL）程度与 SPM 不同。从 MPM 患者中分离的 PBMC 中 CXCL6 和 FOXJ1 的表达增加。
与 SPM 患者相比，MPM 患者的 RFS 和 OS 更差。还观察到免疫差异，包括 MPM 患者 PBMC 中的 TIL 含量和 CXCL6/FOXJ1 的表达，这值得进一步研究。
