Metastatic melanomas of unknown primary show better prognosis than those of known primary: A systematic review and meta-analysis of observational studies

Jung Min Bae; Yoon Young Choi; Dae Suk Kim; Ji Hye Lee; Hong Sun Jang; Joo Hee Lee; Heesu Kim; Byung Ho Oh; Mi Ryung Roh; Kyoung Ae Nam; Kee Yang Chung

doi:10.1016/j.jaad.2014.09.029

Metastatic melanomas of unknown primary show better prognosis than those of known primary: A systematic review and meta-analysis of observational studies

Jung Min Bae, Yoon Young Choi, Dae Suk Kim, Ji Hye Lee, Hong Sun Jang, Joo Hee Lee, Heesu Kim, Byung Ho Oh, Mi Ryung Roh, Kyoung Ae Nam, Kee Yang Chung

Department of Dermatology

Research output: Contribution to journal › Article › peer-review

45 Citations (Scopus)

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.

Original language	English
Pages (from-to)	59-70
Number of pages	12
Journal	Journal of the American Academy of Dermatology
Volume	72
Issue number	1
DOIs	https://doi.org/10.1016/j.jaad.2014.09.029
Publication status	Published - 2015 Jan 1

Bibliographical note

Funding Information:
This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF- 2013R1A2A2A04015894 ).

Publisher Copyright:
© 2014 American Academy of Dermatology, Inc.

All Science Journal Classification (ASJC) codes

Dermatology

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10.1016/j.jaad.2014.09.029

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Bae, J. M., Choi, Y. Y., Kim, D. S., Lee, J. H., Jang, H. S., Lee, J. H., Kim, H., Oh, B. H., Roh, M. R., Nam, K. A., & Chung, K. Y. (2015). Metastatic melanomas of unknown primary show better prognosis than those of known primary: A systematic review and meta-analysis of observational studies. Journal of the American Academy of Dermatology, 72(1), 59-70. https://doi.org/10.1016/j.jaad.2014.09.029

Bae, Jung Min ; Choi, Yoon Young ; Kim, Dae Suk ; Lee, Ji Hye ; Jang, Hong Sun ; Lee, Joo Hee ; Kim, Heesu ; Oh, Byung Ho ; Roh, Mi Ryung ; Nam, Kyoung Ae ; Chung, Kee Yang. / Metastatic melanomas of unknown primary show better prognosis than those of known primary : A systematic review and meta-analysis of observational studies. In: Journal of the American Academy of Dermatology. 2015 ; Vol. 72, No. 1. pp. 59-70.

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title = "Metastatic melanomas of unknown primary show better prognosis than those of known primary: A systematic review and meta-analysis of observational studies",

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.",

author = "Bae, {Jung Min} and Choi, {Yoon Young} and Kim, {Dae Suk} and Lee, {Ji Hye} and Jang, {Hong Sun} and Lee, {Joo Hee} and Heesu Kim and Oh, {Byung Ho} and Roh, {Mi Ryung} and Nam, {Kyoung Ae} and Chung, {Kee Yang}",

note = "Funding Information: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF- 2013R1A2A2A04015894 ). Publisher Copyright: {\textcopyright} 2014 American Academy of Dermatology, Inc.",

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Bae, JM, Choi, YY, Kim, DS, Lee, JH, Jang, HS, Lee, JH, Kim, H, Oh, BH, Roh, MR, Nam, KA & Chung, KY 2015, 'Metastatic melanomas of unknown primary show better prognosis than those of known primary: A systematic review and meta-analysis of observational studies', Journal of the American Academy of Dermatology, vol. 72, no. 1, pp. 59-70. https://doi.org/10.1016/j.jaad.2014.09.029

Metastatic melanomas of unknown primary show better prognosis than those of known primary : A systematic review and meta-analysis of observational studies. / Bae, Jung Min; Choi, Yoon Young; Kim, Dae Suk; Lee, Ji Hye; Jang, Hong Sun; Lee, Joo Hee; Kim, Heesu; Oh, Byung Ho; Roh, Mi Ryung; Nam, Kyoung Ae; Chung, Kee Yang.

In: Journal of the American Academy of Dermatology, Vol. 72, No. 1, 01.01.2015, p. 59-70.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Metastatic melanomas of unknown primary show better prognosis than those of known primary

T2 - A systematic review and meta-analysis of observational studies

AU - Bae, Jung Min

AU - Choi, Yoon Young

AU - Kim, Dae Suk

AU - Lee, Ji Hye

AU - Jang, Hong Sun

AU - Lee, Joo Hee

AU - Kim, Heesu

AU - Oh, Byung Ho

AU - Roh, Mi Ryung

AU - Nam, Kyoung Ae

AU - Chung, Kee Yang

N1 - Funding Information: This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (NRF- 2013R1A2A2A04015894 ). Publisher Copyright: © 2014 American Academy of Dermatology, Inc.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - 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.

AB - 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.

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Metastatic melanomas of unknown primary show better prognosis than those of known primary: A systematic review and meta-analysis of observational studies

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