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Treatment and outcomes of melanoma in Asia: Results from the National Cancer Centre Singapore
Author(s) -
Teh Yi Lin,
Goh Wei Lin,
Tan Sze Huey,
Yong Grace,
Sairi Alisa Noor Hidayah,
Soo Khee Chee,
Ong Johnny,
Chia Claramae,
Tan Grace,
Soeharno Henry,
Tan Mann Hong,
Chan Michelle,
Sathiyamoorthy Selvarajan,
Sittampalam Kesavan,
Teh Jonathan,
Chin Francis,
Sethi Vijay,
Teo Melissa,
Quek Richard,
Farid Mohamad
Publication year - 2018
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12802
Subject(s) - medicine , stage (stratigraphy) , melanoma , cancer , proportional hazards model , biopsy , lymph node , adverse effect , oncology , dermatology , surgery , paleontology , cancer research , biology
Background Acral melanoma (AM) and mucosal melanoma (MM) make up more than half of melanomas in Asia but comprise only 5% of cases in Caucasians, where cutaneous melanoma (CM) predominates. AM and MM are thought to be genetically and biologically distinct from CM. We report the characteristics and outcomes of melanoma patients from the National Cancer Centre Singapore. Methods Case records of 210 patients treated between 2002 and 2014 were reviewed. Results Median follow‐up was 2.5 years. CM, AM and MM made up of 37.6%, 33.8% and 16.2% of cases, respectively, with 6.2% each having ocular melanoma and unknown primary. Caucasians made up 16.2% of patients, accounting for 36.7% of CM but only 2.8 of AM and 2.9% of MM. Patients with MM (2.9% stage I, 14.7% stage IV) presented with higher American Joint Committee on Cancer (AJCC) stage than those with AM (16.9% stage I, 5.6% stage IV) or CM (24.1% stage I, 8.9% stage IV) ( P = 0.01). Median overall survival (OS) was 5.7 years for all patients, and 1.0 year for metastatic disease. Considering stage I–III disease, multivariable Cox regression analysis demonstrated age ≥60 years and higher stage to be independent adverse prognostic factors for RFS and OS. Sentinel lymph node biopsy, undertaken for 56 stage I–III patients (25 AM, 31 CM) did not influence outcome. Conclusion Our study reinforces the known unique clinicopathologic features of melanomas in Asians where AM and MM predominate. Age and stage remain the most critical prognostic factors across all subtypes.