Diagnostics and therapy of patients with melanoma of unknown primary site

Abstract

Background. Diagnostics and quality treatment improvement of patients with Metastases of Unknown Primary Site Melanoma. Methods. A retrospective chart review of patient’s medical histories and outpatient’s charts were carried out relating to 581 patients with Metastases of Unknown Primary Site Malignances (MUPSM) who were examined and treated in the Clinical Oncological Dispensary, Ministry of Health Care, Tatarstan Republic, Kazan City, Russia, over the period from 1996 until 2008. Based on histological examination of metastases, 36 patients were diagnosed with melanoma. Results. The number of patients with Metastases of Unknown Primary Site Melanoma was 6,2% of total number of patients with MUPSM (Metastases of Unknown Primary Site Malignances). It was confirmed by immunohistochemical examination as a principle method of morphological diagnosis in the above group of patients with Metastases of Unknown Primary Site Melanoma. The survival rate of the patients with Metastases of Unknown Primary Site Melanoma were correlated with the survival rate of the patients with similarly advanced metastases but with diagnosed Primary Origin. The five-year survival rates for the stage IIIC were 18,2% and 18,4% (p=0,042); for the stage IV are 7,1% and 6,0% (p=0,078) respectively. Conclusion. It is worthwhile to define the stage of the diagnosed Metastases of Unknown Primary Site Melanoma in accordance with TNM-'2002 classification. The survival rate of the above group of patients is comparable to the results, obtained in the patients group with diagnosed primary origin. The missing primary site in metastatic melanoma is not a factor which significantly affects the survival rates of the above groups of patients.