Association of Time From Primary Diagnosis to First Distant Relapse of Metastatic Melanoma With Progression of Disease and Survival - Université de Montpellier
Article Dans Une Revue JAMA Dermatology Année : 2019

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

1 Service de Dermatologie [AP-HP Hôpital Saint-Louis]
2 Centre de Diagnostic et de Thérapeutique, Hôpital de l’Hôtel-Dieu [Paris]
3 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
4 CHLS - Centre Hospitalier Lyon Sud [CHU - HCL]
5 CHU Bordeaux
6 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
7 INSERM U823 - Institut d'oncologie/développement Albert Bonniot de Grenoble
8 Hôpital du Bocage
9 BECCOH - Biomarqueurs et essais cliniques en Cancérologie et Onco-Hématologie
10 INCa - Institut national du cancer
11 Service de Dermatologie [Nice]
12 CHRU Brest - Centre Hospitalier Régional Universitaire de Brest
13 Centre Hospitalier Annecy-Genevois [Saint-Julien-en-Genevois]
14 AP-HP - Hôpital Bichat - Claude Bernard [Paris]
15 Département d'oncologie médicale [Rennes]
16 Service de dermatologie [CHU d'Amiens-Picardie]
17 Département de dermatologie
18 Service de Dermatologie et Allergologie [CHRU Nancy]
19 IBMM - Institut des Biomolécules Max Mousseron [Pôle Chimie Balard]
20 Service de dermatologie [Avicenne]
21 CRCNA - Centre de Recherche en Cancérologie Nantes-Angers
22 Service de dermatologie [Nantes]
23 LDPM - Laboratoire Dynamique des Protéines et Modélisation
24 CRESS (U1153 / UMR_A_1125 / UMR_S_1153) - Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité
25 Hôpital Hôtel-Dieu [Paris]
26 IDO (U976 / UMR_S 976) - Immunologie, dermatologie, oncologie ; Oncodermatologie, immunologie et cellules souches cutanées
Stéphane Dalle
Caroline Dutriaux
  • Fonction : Auteur
Sophie Dalac
Jean-Philippe Lacour

Résumé

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.

Domaines

Cancer Dermatologie

Dates et versions

hal-02863397 , version 1 (27-09-2024)

Identifiants

Citer

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, 2019, 155 (6), pp.673. ⟨10.1001/jamadermatol.2019.0425⟩. ⟨hal-02863397⟩
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