Survival rates of patients with metastatic malignant melanoma

A Sandru, S Voinea, E Panaitescu, A Blidaru, A Sandru, S Voinea, E Panaitescu, A Blidaru

Abstract

Rationale: Malignant melanoma (MM) is the cutaneous neoplasia with the greatest mortality rates and one of the malignancies with the highest potential of dissemination. The prognosis of patients with metastatic MM is grim, with a 5-years survival rate between 5-19%, and is dictated by the location and the number of metastases.

Objective: We aimed to estimate the survival of patients with metastatic MM from our study and find out if the metastasis' location influences survival.

Methods and results: Between 2008 and 2013, 155 patients with cutaneous MM were diagnosed in our clinic. All the patients were staged according to 2009 AJCC staging system. The median follow-up period was of 24 months. Survival was calculated by using the Kaplan-Meier method with a confidence level of 95%. 40.5% of the patients developed metastases in different organs, especially the brain. 80.6% of those with metastases died during the study. The median overall survival, estimated for the entire group of patients who developed metastases, was of 5.3 months.

Discussion: The influence of metastases distribution on the overall survival was examined and it was noticed that there were statistically significant differences between the risks of death of various groups of patients, depending on metastasis topography. Thus, the death probability of a patient with brain metastases is twice that of a patient with digestive metastasis, about 7 times higher than that of a patient with lung metastasis (p=0.0004) and 12 times higher than the death risk of a patient with extra-regional lymph nodes or subcutaneous metastasis (p=0.0000).

Keywords: malignant melanoma; metastasis distribution; survival rates.

Figures

Fig. 1
Fig. 1
Kaplan-Meier overall survival for all stage IV patients: + censored patients
Fig. 2
Fig. 2
Kaplan Meier overall survival for stage IV MM patients depending on the first metastatic site Blue line – brain metastasis; red line – digestive metastasis; purple line – lung metastasis; green line - subcutaneous and extra-regional lymph nodes metastasis

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