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Association of Time From Primary Diagnosis to First Distant Relapse of Metastatic Melanoma With Progression of Disease and Survival

Anaïs Vallet 1 Bastien Oriano 2 Laurent Mortier 3 Stéphane Dalle 4 Caroline Dutriaux 5 Bernard Guillot 6 Marie-Thérèse Leccia 7 Sophie Dalac 8 Philippe Saiag 9, 10 Jean-Philippe Lacour 11 Delphine Legoupil 12 Julie de Quatrebarbes 13 Florence Brunet-Possenti 14 Thierry Lesimple 15 Jean-Philippe Arnault 16 François Aubin 17 Florence Granel-Brocard 18 Pierre-Emmanuel Stoebner 19, 6 Eve Maubec 20 Brigitte Dréno 21, 22 Clara Allayous 23, 1 Raphael Porcher 24, 25 Céleste Lebbé 26, 1
Abstract : 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 (<12 months, 12-24 months, and >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.
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https://hal.umontpellier.fr/hal-02863397
Contributeur : Nathalie Salvy-Cordoba <>
Soumis le : mercredi 10 juin 2020 - 11:10:37
Dernière modification le : vendredi 2 avril 2021 - 03:37:01

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Anaïs Vallet, Bastien Oriano, Laurent Mortier, Stéphane Dalle, Caroline Dutriaux, et al.. Association of Time From Primary Diagnosis to First Distant Relapse of Metastatic Melanoma With Progression of Disease and Survival. JAMA Dermatology, American Medical Association, 2019, 155 (6), pp.673. ⟨10.1001/jamadermatol.2019.0425⟩. ⟨hal-02863397⟩

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