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Association of Time From Primary Diagnosis to First Distant Relapse of Metastatic Melanoma With Progression of Disease and Survival
- Source :
- JAMA Dermatol, JAMA Dermatology, JAMA Dermatology, American Medical Association, 2019, 155 (6), pp.673. ⟨10.1001/jamadermatol.2019.0425⟩
- Publication Year :
- 2019
- Publisher :
- American Medical Association, 2019.
-
Abstract
- International audience; The prognosis of advanced melanoma has been greatly improved by new therapeutic agents and clinicians rely on dynamic signals to drive their therapeutic choices. Although the kinetics of metastatic disease seem to be correlated with survival, progression of the localized disease is not predictable.Objective: To assess whether progression of metastatic disease is associated with the time to the first distant recurrence of melanoma.Design, Setting, and Participants: This study was conducted from March 1, 2013, to September 1, 2017, among 638 adults with unresectable stage III or IV melanoma within the French multicentric prospective cohort MelBase. Patients treated with first-line immunotherapies, targeted therapies, or chemotherapy were included. Patients with unknown primary or de novo metastatic melanoma were not included. Data were analyzed from March 1, 2013, to December 1, 2017.Main Outcomes and Measures: The date of primary excision and time to first distant recurrence, progression-free survival, and overall survival were collected. Cox proportional hazards regression models were planned to assess the association between time to first distant recurrence and progression-free survival or overall survival, which was evaluated in terms of hazard ratio (HR). Time to recurrence was analyzed both as a continuous and categorical variable (24 months).Results: A total of 638 patients (272 women and 366 men; median age, 64 years [interquartile range, 52-73 years]) were included in the study. The median time from primary excision to first distant recurrence was 25 months (interquartile range, 12-55 months). There was no evidence of association of the time to recurrence with progression-free survival, both when analyzed as a continuous variable (HR, 0.99; 95% CI, 0.99-1.01) or after categorization (12-24 months: HR, 0.75; 95% CI, 0.56-1.02; >24 months: HR, 0.62; 95% CI; 0.47-1.01). There was no evidence of association of the time to recurrence with overall survival, both when analyzed as a continuous variable (HR, 0.99; 95% CI, 0.98-1.02) or after categorization (12-24 months: HR, 0.76; 95% CI, 0.54-1.07; >24 months: HR, 0.61; 95% CI, 0.54-1.03). Those results remained nonsignificant after stratification by treatment.Conclusions and Relevance: In the MelBase cohort, time to recurrence of metastatic melanoma appears not to be associated with progression-free survival or overall survival.
- Subjects :
- Male
Oncology
medicine.medical_specialty
Skin Neoplasms
Time Factors
[SDV.CAN]Life Sciences [q-bio]/Cancer
Dermatology
Cohort Studies
030207 dermatology & venereal diseases
03 medical and health sciences
0302 clinical medicine
Interquartile range
Internal medicine
medicine
Humans
Prospective Studies
Progression-free survival
Neoplasm Metastasis
Stage (cooking)
Prospective cohort study
Melanoma
Aged
Original Investigation
business.industry
Hazard ratio
MESH: Cohort studies
Melanoma/diagnosis
Middle aged
Skin neoplasms/diagnosis
Survival rate
Progression-Free survival
Middle Aged
Prognosis
Chemotherapy regimen
Progression-Free Survival
3. Good health
Survival Rate
030220 oncology & carcinogenesis
Localized disease
Cohort
Disease Progression
Female
France
Neoplasm Recurrence, Local
business
[SDV.MHEP.DERM]Life Sciences [q-bio]/Human health and pathology/Dermatology
Subjects
Details
- Language :
- English
- ISSN :
- 21686068 and 21686084
- Database :
- OpenAIRE
- Journal :
- JAMA Dermatol, JAMA Dermatology, JAMA Dermatology, American Medical Association, 2019, 155 (6), pp.673. ⟨10.1001/jamadermatol.2019.0425⟩
- Accession number :
- edsair.doi.dedup.....6d50085cf7a593e61cdb95478601f942
- Full Text :
- https://doi.org/10.1001/jamadermatol.2019.0425⟩