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    Hypothesised cutaneous sites of origin of stage III melanomas with unknown primary: A multicentre study

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    Authors
    Clayton, Bethan
    Muneeb, Furhan
    Hughes, M. C. B.
    Grant, Megan E
    Khosrotehrani, K.
    Smithers, B. M.
    Spina, R.
    Campana, Luca G
    Oudit, Deemesh
    Green, Adèle C
    Affiliation
    Department of Surgery, The Christie NHS Foundation Trust, Manchester, UK
    Issue Date
    2022
    
    Metadata
    Show full item record
    Abstract
    Based on molecular evidence that melanomas with unknown primary (MUPs) arise from the skin, we hypothesised that sites of MUPs are disproportionately on trunk and lower limbs, sites that are not readily visible to patients and clinicians. We tested this hypothesis by inferring the anatomic site of origin of MUPs from the corresponding known cutaneous sites of melanoma patients with known primary tumours (MKPs). We analysed data from three separate cohorts of patients from Brisbane, Australia (n = 236); Manchester, UK (n = 51) and Padova, Italy (n = 33), respectively, who first presented with stage III melanoma with lymph node metastases. We matched two MKP patients to each MUP patient based on lymph node dissection (LND) site, age and sex, and imputed cutaneous sites of origin of MUPs from their two matched MKPs for study countries, giving two possible sites for each MUP per centre. Overall, results showed that MUP patients were predominantly male, and trunk was the most likely origin, comprising around a third to a half of MUPs across the three cohorts. The remaining MUP inferred sites varied by country. In the Australian cohort, the legs accounted for a third of imputed sites of MUPs, while in the UK and Italian cohorts, the most frequent site was the arms followed by the legs. Our findings suggest the need for regular and thorough skin examination on trunk and limbs, especially in males, to improve early detection of cutaneous melanoma and reduce the risk of metastatic disease at the time of presentation.
    Citation
    Clayton B, Muneeb F, Hughes MCB, Grant ME, Khosrotehrani K, Smithers BM, et al. Hypothesised cutaneous sites of origin of stage III melanomas with unknown primary: A multicentre study. International Journal of Cancer. Wiley; 2022.
    Journal
    International Journal of Cancer
    URI
    http://hdl.handle.net/10541/625215
    DOI
    10.1002/ijc.34020
    PubMed ID
    35403698
    Additional Links
    https://dx.doi.org/10.1002/ijc.34020
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1002/ijc.34020
    Scopus Count
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