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Metastatic patterns and metastatic sites in mucosal melanoma: a retrospective study

  • Oncology
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Abstract

Objectives

Melanomas arising from mucosa are rare and associated with a poor prognosis. This study aims to provide an analysis of metastatic pathways, time intervals, factors influencing metastatic spread and organs for distant metastases.

Methods

A total of 116 patients with mucosal melanomas of different sites were included. The mean follow-up interval was 47 ± 52 months. Patients were assigned to two different metastatic pathways, either presenting loco-regional lymph node metastases as first spread or direct distant metastases. The distribution of distant metastases was assessed.

Results

Twenty-six patients presented with a pre-existing metastatic spread and were not assigned to pathways. Of the included patients, 44 developed metastases after treatment of the primary tumour; 25 patients directly developed distant metastases; 16 patients developed regional lymph node metastases prior to distant metastases. Location of the primary tumour in the upper airway or GI tract and advanced T stage were significant risk factors of direct distant metastases. Distant metastases are mainly located in the lung, the liver and non-regional lymph nodes.

Conclusions

Mucosal melanomas show a high rate of direct distant metastases rather than regional lymph node metastases. Thus the follow-up should always include a whole-body cross-sectional imaging in high-risk tumours.

Key points

• Mucosal melanomas show a high rate of direct distant metastases.

• T stage and primary location are predictors for direct distant metastases.

• Distant metastases were mainly found in lung, liver and lymph nodes.

• Follow-up of a high-risk mucosal melanoma should include whole-body imaging.

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Acknowledgments

We would like to thank Ms. Aline Naumann from the Department of Biostatistics, University of Tübingen, for her excellent advice and support.

The scientific guarantor of this publication is Prof. Stephan Clasen, MD. The authors of this manuscript declare no relationships with any companies whose products or services may be related to the subject matter of the article. The authors state that this work has not received any funding. No complex statistical methods were necessary for this paper. Institutional review board approval was obtained. Written informed consent was waived by the institutional review board. Methodology: retrospective study, observational, study performed at one institution.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, University hospital Tübingen, Hoppe- Seylerstr. 3, 72076, Tübingen, Germany

    Gerd Grözinger, Steven Mann, Bernhard Klumpp, Ulrich Grosse, Konstantin Nikolaou & Stephan Clasen

  2. Department of Dermatology, University hospital Tübingen, Liebermeisterstraße 25, 72076, Tübingen, Germany

    Tarun Mehra & Claus Garbe

Authors
  1. Gerd Grözinger
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  2. Steven Mann
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  3. Tarun Mehra
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  4. Bernhard Klumpp
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  6. Konstantin Nikolaou
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  7. Claus Garbe
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  8. Stephan Clasen
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Corresponding author

Correspondence to Gerd Grözinger.

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Fig. 1

Estimated cumulative incidence curves with metastasis and death before metastasis as competing events (n = 116) (GIF 18 kb)

High resolution image (TIFF 123 kb)

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Grözinger, G., Mann, S., Mehra, T. et al. Metastatic patterns and metastatic sites in mucosal melanoma: a retrospective study. Eur Radiol 26, 1826–1834 (2016). https://doi.org/10.1007/s00330-015-3992-9

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  • DOI: https://doi.org/10.1007/s00330-015-3992-9

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