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van Beek EJ, Balm AJ, Nieweg OE, et al. Treatment of Regional Metastatic Melanoma of Unknown Primary Origin. Cancers (Basel). 2015;7(3):1543-53doi: 10.3390/cancers7030849.
van Beek, E. J., Balm, A. J., Nieweg, O. E., Hamming-Vrieze, O., Lohuis, P. J., & Klop, W. M. (2015). Treatment of Regional Metastatic Melanoma of Unknown Primary Origin. Cancers, 7(3), 1543-53. https://doi.org/10.3390/cancers7030849
van Beek, Elke J A H, et al. "Treatment of Regional Metastatic Melanoma of Unknown Primary Origin." Cancers vol. 7,3 (2015): 1543-53. doi: https://doi.org/10.3390/cancers7030849
van Beek EJ, Balm AJ, Nieweg OE, Hamming-Vrieze O, Lohuis PJ, Klop WM. Treatment of Regional Metastatic Melanoma of Unknown Primary Origin. Cancers (Basel). 2015 Aug 10;7(3):1543-53. doi: 10.3390/cancers7030849. PMID: 26266423; PMCID: PMC4586782.
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Cancers (Basel). 2015 Aug 10;7(3):1543-53. doi: 10.3390/cancers7030849.

Treatment of Regional Metastatic Melanoma of Unknown Primary Origin.

Cancers

Elke J A H van Beek, Alfons J M Balm, Omgo E Nieweg, Olga Hamming-Vrieze, Peter J F M Lohuis, W Martin C Klop

Affiliations

  1. Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121,, 1066CX, Amsterdam, The Netherlands. [email protected].
  2. Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121,, 1066CX, Amsterdam, The Netherlands. [email protected].
  3. Melanoma Institute Australia, 40 Rocklands Rd, North Sydney NSW 2060, Australia. [email protected].
  4. Department of Radiotherapy, The Netherlands Cancer Institute-Antoni van Leeuwenhoek,Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands. [email protected].
  5. Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121,, 1066CX, Amsterdam, The Netherlands. [email protected].
  6. Department of Head and Neck Surgery and Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121,, 1066CX, Amsterdam, The Netherlands. [email protected].
  7. Skin and Melanoma Centre, The Netherlands Cancer Institute-Antoni van Leeuwenhoek,Plesmanlaan 121, 1066CX, Amsterdam, The Netherlands. [email protected].

PMID: 26266423 PMCID: PMC4586782 DOI: 10.3390/cancers7030849

Abstract

(1) BACKGROUND: The purpose of this retrospective study was to evaluate the recurrence and survival rates of metastatic melanoma of unknown primary origin (MUP), in order to further refine current recommendations for the surgical treatment; (2) METHODS: Medical data of all MUP patients registered between 2000 and 2011, were analyzed. Seventy-eight patients were categorized in either lymph node (axilla, groin, head-and neck) or subcutaneous MUP. Axillary node MUPs were generally treated with dissections of levels I-III, inguinal node MUPs with combined superficial and deep groin dissections, and head-and-neck node MUPs with neck dissections to various extents, based on lymph drainage patterns. Subcutaneous lesions were excised with 1-2 cm margins. The primary outcome was treatment outcomes in terms of (loco)regional recurrence and survival rates; (3) RESULTS: Lymph node MUP recurred regionally in 11% of patients, with an overall recurrence rate of 45%. In contrast, subcutaneous MUP recurred locally in 65% of patients with an overall recurrence rate of 78%. This latter group had a significantly shorter disease-free interval than patients with lymph node MUP (p = 0.000). In the entire study population, 5-year and 10-year overall survival rates were 56% and 47% respectively, with no differences observed between the various subgroups; (4) CONCLUSION: The relatively low regional recurrence rate after regional lymph node dissection (11%) supports its current status as standard surgical treatment for lymph node MUP. Subcutaneous MUP, on the contrary, appears to recur both locally (65%) and overall (78%) at a significantly higher rate, suggesting a different biological behavior. However, wide local excision remains the best available option for this specific group.

Keywords: melanoma; surgical treatment; unknown primary

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