METASTATIC MELANOMA WITHOUT CLINICALLY EVIDENT PRIMARY TUMOR
https://doi.org/10.21294/18144861-2017-16-2-79-85
Abstract
The purpose of the study was to systematize the data available in the modern literature on the diagnosis and treatment of metastatic melanoma without clinically evident primary tumor. Materials and methods. The results of laboratory-instrumental diagnostics, surgical and drug treatment presented in randomized clinical trials, published over the past 10 years in Medline, Embase and the Cochrane Library were analyzed. Results. Despite continuous improvement in imaging techniques, melanoma accounts for up to 12.6 % of all cases of metastatic cancer with an unknown primary site. Metastatic melanoma without clinical evidence of primary tumor accounts for approximately 1% to 8% of all melanoma cases. Conclusion. Metastatic melanoma without clinically evident primary tumor has not been extensively studied. Until now, only a few reports on metastatic melanoma without clinically evident primary tumor have been available. Therefore, further prospective studies of clinical course and optimization of diagnosis and treatment of patients with metastatic melanoma without clinically evident primary tumor are needed.
About the Authors
V. Sh. Rzaeva
N.N. Petrov Institute of Oncology, Saint-Petersburg
Russian Federation
Russian Federation
MD, postgraduate, Scientific Department of General Oncology and Urology
SPIN-code: 2555-9895
68, Leningradskay Street, 197758-Saint-Petersburg, township Pesochnyjj
G. I. Gafton
N.N. Petrov Institute of Oncology, Saint-Petersburg;
I.P. Pavlov First Saint-Petersburg State Medical University, Saint-Petersburg
Russian Federation
Russian Federation
MD, DSc, Head of Scientific Department of General Oncology and Urology
68, Leningradskay Street, 197758-Saint-Petersburg, township Pesochnyjj
6–8, L’va Tolstogo, 197022-Saint-Petersburg
V. V. Anisimov
N.N. Petrov Institute of Oncology, Saint-Petersburg
Russian Federation
Russian Federation
MD, DSc, Leading Researcher of Scientific Department of General Oncology and Urology
SPIN-code: 5156-2196
68, Leningradskay Street, 197758-Saint-Petersburg, township Pesochnyjj
Y. V. Semiletova
N.N. Petrov Institute of Oncology, Saint-Petersburg;
I.I. Mechnikov North-Western State Medical University, Saint-Petersburg
Russian Federation
Russian Federation
MD, PhD, Assistant of Oncology Department
68, Leningradskay Street, 197758-Saint-Petersburg, township Pesochnyjj
41, Kirochnaya Street, 191015-Saint-Petersburg
M. Yu. Myasnyankin
N.N. Petrov Institute of Oncology, Saint-Petersburg
Russian Federation
Russian Federation
MD, PhD, Physician
68, Leningradskay Street, 197758-Saint-Petersburg, township Pesochnyjj
I. G. Gafton
N.N. Petrov Institute of Oncology, Saint-Petersburg
Russian Federation
Russian Federation
MD, PhD, Physician
68, Leningradskay Street, 197758-Saint-Petersburg, township Pesochnyjj
References
1. Vagner R.I., Anisimov V.V., Barchuk A.S. Melanoma of the skin. Part 1. SPb., 1995. 151 p. [in Russian]
2. Novinskaya М.М. Clinica and treatment of melanomas. Moscow, 1970. 184 p. [in Russian]
3. Vagner R.I., Anisimov V.V., Barchuk A.S. Melanoma of the skin. Part 2. SPb., 1996. 280 p. [in Russian]
4. Baab G.H., Bride C.M. Malignant melanoma. The patient with an known site of primary origin. Arch Surg. 1975. 110 (8): 896–900.
5. Rudyk A.N., Zinchenko S.V., Khasanov R.Sh., Khamidullin R.G., Chernyshev V.A.Diagnosis and treatment outcomes in patients with squamous cell cancer metastases in lymph nodes of the neck with no detectable primary tumor. Siberian Journal of Oncology. 2010; 1: 64–67. [in Russian]
6. Merabishvili V.M. Malignant Melanoma-up-to-date tendencies (the morbidity, the mortality, the diagnostics). Oncological issues. 2006; 3: 275–287.
7. Zinchenko S.V., Khasanov R.Sh., Rudyk A.N. On the classification of metastases of malignant tumors with unidentified primary focus. Kazan Medical Journal. 2010; 91 (2): 246–248. [in Russian]
8. Chissov V.I., Starinskiy V.V., Petrova G.V. Malignant neoplasms in Russia in 2011 (morbidity and mortality). Moscow, 2013. 289 p. [in Russian]
9. Anisimov V.V., Radzhpova Z.A., Vesnin A.G., Barchuk A.S. Evaluation of the method of regional spread of the tumor process in patients with primary skin melanoma – Advanced medical technology. SPb., 2008. [in Russian]
10. Zinchenko S.V., Rudyk A.N., Khasanov R.Sh. Treatment of patients with metastases of malignant tumors without an identified primary focus. Vestnik RONC im. N.N. Blochina RAMN. 2009; 20 (3): 3–12. [in Russian]
11. Cormier J.N., Xing Y., Feng L., Huang X., Davidson L., Gershenwald J.E., Lee J.E., Mansfield P.F., Ross M.I. Metastatic Melanoma to Lymph Nodes in Patients with Unknown Primary Sites. Cancer. 2006 May 1; 106 (9): 2012–20.
12. Marochko A.Yu., Kosykh N.E., Briancheva A.I., Borovckaya T.F., Mayatskaya T.M., Krylova I.E., Zmeul V.K. Metastases of melanoma without an identified primary focus. Russian Far East Medical Journal. 2009; 1: 47–49. [in Russian]
13. Das Gupta T., Bowden L., Berg J.W. Malignant melanoma of unknown primary origin. Surg Gynecol Obstet. 1963; 117: 341–5.
14. Ahmetov I.R. Melanoma of the skin: tactics of surgical treatment for regional lymph nodes. Siberian Journal of Oncology. 2006; 3: 68–73. [in Russian]
15. Komarov I.G., Komov D.V. Metastases of malignant tumors without an identified primary focus. In book: Oncology / Ed. by I.V. Poddubnaya. Moscow, 2009: 750–757. [in Russian]
16. Gafur-Akhunov M.A., Amiraslanov A.T., Parshikov S.M., Demidov L.V., Yavorskiy V.V., Fedotenko S.P. Metastasis of melanoma in peripheral lymph nodes without an identified primary focus.. Vestnik RONC im. N.N. Blochina RAMN. 1991; 3: 24–27. [in Russian]
17. Savoia P., Fava P., Osella-Abate S., Nardò T., Comessatti A., Quaglino P., Bernengo M.G. Melanoma of unknown primary site: a 33-year experience at the turin melanoma centre. Melanoma Res. 2010; 20: 227–32.
18. Samadder N.J., Smith K.R., Hanson H., Pimentel R.. , Wong J., Boucher K., Akerley W., Gilcrease G., Ulrich C.M., Burt R.W., Curtin K. Familial risk in patients with carcinoma of unknown primary. JAMAOncol. 2016 Mar; 2 (3): 340–6. doi: 10.1001/jamaoncol.2015.4265.
19. Manola J., Ibrahim J., Atkins M., Kirkwood J. Prognostic factors in metastatic. J Clin Oncol. 2000 Nov 15;18 (22): 3782–93.
20. Miller F.R., Kamad A.B., Eng T., Hussey D.H., McGuff H.S., Otto R.A. Management of unknown primary carcinoma: long-term followup on a negative PET Scan and negative panendoscopy. Head Neck. 2008 Jan; 30 (1): 28–34.
21. Chen Y.H., Yang X.M., Li S.S., Wang Y.H., He J.J., Yang Y.D., Wang S., Liu J.J., Zhang X.L. Value of fused positron emission tomography CT in detecting primaries in patients with primary unknown cervical lymph node metastasis. J Med Imaging Radiat Oncol. 2012; 56 (1): 66–74. doi: 10.1111/j.1754-9485.2011.02331.x.
22. Guarischi A., Keane T.J., Elhakim T. Metastic inguinal nodes from an unknown primary neoplasm. A review of 56 cases. Cancer (Philad.). 1987; 59 (3): 572–577.
23. Anisimov V.V. Standard examination of patients with suspected melanoma. Modern clinical classification. Practical Oncology. 2001; 4: 12–22. [in Russian]
24. Manual on immunohistochemical diagnostics of human tumors / Eds. S.V. Petrov. N.T. Raykhlin. Kazan, 2012. 624 p. [in Russian]
25. Strojan P., Ferlito A., Medina J.E., Woolgar J.A., Rinaldo A., RobbinsK.T.,FaganJ.J.,MendenhallW.M.,PaleriV.,SilverC.E.,OlsenK.D., Corry J., Suárez C., Rodrigo J.P., Langendijk J.A., Devaney K.O., Kowalski L.P., Hartl D.M., Haigentz M.Jr, Werner J.A., Pellitteri P.K., de Bree R., Wolf G.T., Takes R.P., Genden E.M., Hinni M.L., Mondin V., Shaha A.R., Barnes L. Contemporary management of lymph node metastases from an unknown primary to the neck: I. A review of diagnostic approaches. Head Neck. 2011 Jan; 35 (1): 123-32. doi: 10.1002/hed.21898.
26. Starritt E.C., Uren R.F., Scolyer R.A., Quinn M.J., Thompson J.F. Ultrasound Examination of Sentinel Nodes in the Initial Assessment of Patients With Primary Cutaneous Melanoma. Ann Surg Oncol. 2005; 12 (1). 18–23. doi: 10.1245/ASO.2005.03.019
27. Velez A., Walsh D., Constantine P. Karakousis. Treatment of Unknown Primary Melanoma. Cancer. 1991 Dec 15; 68 (12): 2579–81.
28. Novik A.V., Moiseenko V.M. Diagnosis and treatment of tumors of unknown primary localization. Problems in oncology. 2004; 3: 271–278. [in Russian]
29. Vishnevskaya Ya.V., Stroganova A.M., Senderovich A.I., Poluertova Yu.V., Mashenkina Ya.A., Utyashev I.A. Modern histological, immunohistochemical and molecular-genetic diagnostics of skin melanoma. Siberian Journal of Oncology. 2012; 4: 74–75. [in Russian]
30. Bollag G., Tsai J., Zhang J., Zhang C., Ibrahim P., Nolop K., Hirth P. Vemurafenib: the first drug approved for BRAF-mutant cancer. Nat Rev Drug Discov. 2012; 11 (11): 873–86. doi: 10.1038/nrd3847
31. Ballantyne A.D., Garnock-Jones K.P. Dabrafenib: first global approval. Drugs. 2013; 73 (12): 1367–76. doi: 10.1007/s40265-013-0095-2.
32. Wright C.J., McCormack P.L. Trametinib: first global approval. Drugs. 2013; 73 (11): 1245–54. doi: 10.1007/s40265-013-0096-1.
33. Blank C., Brown I., Peterson A.C., Spiotto M., Iwai Y., Honjo T., Gajewski T.F. PD-L1/B7H-1 inhibits the effector phase of tumor rejection by T cell receptor (TCR) transgenic CD8+ T cells. Cancer Res. 2004; 64 (3): 1140–45.
34. Okazaki T., Honjo T. PD-1 and PD-1 ligands: from discovery to clinical application. Int. Immunol. 2007; 19 (7): 813–24.
35. Abramov M.E. Modern Advances in Drug Therapy for Disseminated Skin Melanoma. Farmateka. 2015; 18 (311). [in Russian]
36. Postow M.A., Callahan M.K., Wolchok J.D. Immune Checkpoint Blockade in Cancer Therapy. J Clin Oncol. 2015; 33 (17): 191–9. doi: 10.1200/JCO.2014.59.4358.
37. Chin L., Garraway L.A., Fisher D.E. Malignant melanoma: genetics and therapeutics in the genomic era. US Genes Dev. 2006. Vol. 20 (16): 2149–82.
38. Kamposioras K., Pentheroudakis G., Pectasides D., Pavlidis N. Malignant melanoma of uknown primary site. To make the long story short. A systematic review of the literature. Crit Rev Oncol Hematol. 2011; 78 (2): 112–26. doi: 10.1016/j.critrevonc.2010.04.007.
39. Milton G.W., Shaw H.M., Mecarthy W.H. Occult primary malignant melanoma; factors influeneing survival. Brit J Surg. 1977. 64 (11): 805–808.
Review
For citations:
Rzaeva V.Sh., Gafton G.I., Anisimov V.V., Semiletova Y.V., Myasnyankin M.Yu., Gafton I.G. METASTATIC MELANOMA WITHOUT CLINICALLY EVIDENT PRIMARY TUMOR. Siberian journal of oncology. 2017;16(3):79-85. (In Russ.) https://doi.org/10.21294/18144861-2017-16-2-79-85
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