Metastatic melanomas of unknown primary show better prognosis than those of known primary: a systematic review and meta-analysis of observational studies.
J Am Acad Dermatol
; 72(1): 59-70, 2015 Jan.
Article
em En
| MEDLINE
| ID: mdl-25440435
ABSTRACT
BACKGROUND:
Melanoma of unknown primary (MUP) is a condition of metastatic melanoma without a primary lesion.OBJECTIVE:
We sought to identify the prognosis of MUP compared with melanoma of known primary (MKP).METHODS:
We searched for observational studies containing at least 10 patients with MUP from MEDLINE and EMBASE from inception to December 22, 2012. The outcomes of interest were overall and disease-free survival; meta-analyses of hazard ratio stratified by stage using a random effects model were performed. In addition, second systematic review identified risk factors influencing the survival of patients with MUP.RESULTS:
Eighteen studies including 2084 patients with MUP and 5894 with MKP were included. MUP had a better overall survival compared with MKP in stage III (15 studies; hazard ratio 0.83, 95% confidence interval 0.73-0.96, P = .010) and stage IV (6 studies; hazard ratio 0.85, 95% confidence interval 0.75-0.96, P = .008). Secondly, 22 studies including 3312 patients with MUP were reviewed, and increased stage and old age were the risk factors in patients with MUP.LIMITATIONS:
Diverse observational studies were reviewed, and selection and reporting biases are possible.CONCLUSIONS:
The current meta-analyses suggest better survival outcomes in patients with MUP than those in patients with MKP with the same corresponding tumor stage.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias Cutâneas
/
Neoplasias Primárias Desconhecidas
/
Melanoma
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Limite:
Humans
Idioma:
En
Revista:
J Am Acad Dermatol
Ano de publicação:
2015
Tipo de documento:
Article