Metastatic behavior in melanoma: timing, pattern, survival, and influencing factors

Abstract

Metastatic melanoma (MM) is a fatal disease with a rapid systemic dissemination. This study was conducted to investigate the metastatic behavior, timing, patterns, survival, and influencing factors in MM. 214 patients with MM were evaluated retrospectively. Distant metastases (82%) were the most frequent for patients initially metastatic. The median and 1-year survival rates of initially MM patients were 10 months and 41%, respectively. The median time to metastasis for patients with localized disease was 28 months. The timing of appearance of metastases varied minimally; however, times to metastases for distant organs varied greatly. For the first metastatic pathway, more than half of the primary metastases were M1A (57%). These findings were in contrast to the results compared with those with metastatic in diagnosis (P < 0.001). The median and 1-year survival rates of all patients were 12 months and 49%, respectively. Outcome was higher in M1A than visceral metastases (P < 0.001). In conclusion, the fact that over half of all recurrences/metastases occurred within 3 years urges us to concentrate follow-up in the early time periods following diagnosis. Because the clinical behavior of MM is variable, the factors for survival consisting of site and number of metastases should be emphasized.

Figure 1

Overall survival rates of metastatic patients diagnosed at presentation. S: only single-organ metastasis; M: mixed with other distal organ metastases.

Figure 2

Time periods to metastases in metastatic patients with diagnosed during follow-up.

Figure 3

Postmetastatic survival values in metastatic patients diagnosed during follow-up.

Figure 4

Intervals from the date of first metastases to the date of second metastases in metastatic patients who presented twice with metastatic disease.

Figure 5

Intervals between initial metastases and secondary metastases.

Figure 6

The distributions of M stages depend on time of metastasis presentation (%).

Figure 7

The distributions of distant organs depend on time of metastasis presentation (%).