Endoscopic and pathologic findings associated with clinical outcomes of melanoma in the upper gastrointestinal tract

Ji Yong Ahn, Hee Sang Hwang, Young Soo Park, Hyeong Ryul Kim, Hwoon Yong Jung, Jin Ho Kim, Seung Eun Lee, Min Ah Kim

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8 Citations (Scopus)

Abstract

Background. Melanoma that involves the upper gastrointestinal (GI) tract is rare and studies relating to endoscopic and pathologic findings with clinical outcomes are lacking. We reviewed the gross and microscopic patterns of the upper GI tract in primary and metastatic melanoma, and examined their association with clinical outcomes. Methods. Twenty-nine cases of primary esophageal (n = 19) and metastatic gastric and/or duodenal melanoma (n = 10) that were detected during upper GI endoscopy between 1995 and 2011 were retrospectively analyzed. Results. Three types of gross patterns were recognized-nodular pattern in 7 cases, mass-forming pattern in 18 cases, and flat pigmented pattern in 4 cases. In primary esophageal melanoma, 13 patients (68.4 %) underwent surgery and 9 received palliative therapy. Of all cases, 22 patients (75.9 %) died of disease progression; the median overall survival period was 12 months (interquartile range [IQR] 4.5-24.5 months), and from recognition of upper GI tract melanoma the median overall survival period was 9 months (IQR 3.5-17.0 months). In primary esophageal cases, skin melanoma stage better discriminated the patients with good prognosis than the esophageal cancer stage. The flat pigmented gross pattern proved to be a good prognostic factor in primary and metastatic GI tract melanomas (p = 0.016 and p = 0.046, respectively). Conclusions. Melanoma of the GI tract is a highly aggressive disease with a poor prognosis, both in primary and metastatic cases. However, in primary esophageal melanoma, careful inspection of the mucosa during endoscopic examination followed by surgical resection may result in extended survival.

Original languageEnglish
Pages (from-to)2532-2539
Number of pages8
JournalAnnals of Surgical Oncology
Volume21
Issue number8
DOIs
StatePublished - 1 Jan 2014

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Upper Gastrointestinal Tract
Melanoma
Survival
Gastrointestinal Tract
Gastrointestinal Endoscopy
Esophageal Neoplasms
Palliative Care
Disease Progression
Stomach
Mucous Membrane
Skin

Cite this

Ahn, Ji Yong ; Hwang, Hee Sang ; Park, Young Soo ; Kim, Hyeong Ryul ; Jung, Hwoon Yong ; Kim, Jin Ho ; Lee, Seung Eun ; Kim, Min Ah. / Endoscopic and pathologic findings associated with clinical outcomes of melanoma in the upper gastrointestinal tract. In: Annals of Surgical Oncology. 2014 ; Vol. 21, No. 8. pp. 2532-2539.
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abstract = "Background. Melanoma that involves the upper gastrointestinal (GI) tract is rare and studies relating to endoscopic and pathologic findings with clinical outcomes are lacking. We reviewed the gross and microscopic patterns of the upper GI tract in primary and metastatic melanoma, and examined their association with clinical outcomes. Methods. Twenty-nine cases of primary esophageal (n = 19) and metastatic gastric and/or duodenal melanoma (n = 10) that were detected during upper GI endoscopy between 1995 and 2011 were retrospectively analyzed. Results. Three types of gross patterns were recognized-nodular pattern in 7 cases, mass-forming pattern in 18 cases, and flat pigmented pattern in 4 cases. In primary esophageal melanoma, 13 patients (68.4 {\%}) underwent surgery and 9 received palliative therapy. Of all cases, 22 patients (75.9 {\%}) died of disease progression; the median overall survival period was 12 months (interquartile range [IQR] 4.5-24.5 months), and from recognition of upper GI tract melanoma the median overall survival period was 9 months (IQR 3.5-17.0 months). In primary esophageal cases, skin melanoma stage better discriminated the patients with good prognosis than the esophageal cancer stage. The flat pigmented gross pattern proved to be a good prognostic factor in primary and metastatic GI tract melanomas (p = 0.016 and p = 0.046, respectively). Conclusions. Melanoma of the GI tract is a highly aggressive disease with a poor prognosis, both in primary and metastatic cases. However, in primary esophageal melanoma, careful inspection of the mucosa during endoscopic examination followed by surgical resection may result in extended survival.",
author = "Ahn, {Ji Yong} and Hwang, {Hee Sang} and Park, {Young Soo} and Kim, {Hyeong Ryul} and Jung, {Hwoon Yong} and Kim, {Jin Ho} and Lee, {Seung Eun} and Kim, {Min Ah}",
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Endoscopic and pathologic findings associated with clinical outcomes of melanoma in the upper gastrointestinal tract. / Ahn, Ji Yong; Hwang, Hee Sang; Park, Young Soo; Kim, Hyeong Ryul; Jung, Hwoon Yong; Kim, Jin Ho; Lee, Seung Eun; Kim, Min Ah.

In: Annals of Surgical Oncology, Vol. 21, No. 8, 01.01.2014, p. 2532-2539.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Endoscopic and pathologic findings associated with clinical outcomes of melanoma in the upper gastrointestinal tract

AU - Ahn, Ji Yong

AU - Hwang, Hee Sang

AU - Park, Young Soo

AU - Kim, Hyeong Ryul

AU - Jung, Hwoon Yong

AU - Kim, Jin Ho

AU - Lee, Seung Eun

AU - Kim, Min Ah

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N2 - Background. Melanoma that involves the upper gastrointestinal (GI) tract is rare and studies relating to endoscopic and pathologic findings with clinical outcomes are lacking. We reviewed the gross and microscopic patterns of the upper GI tract in primary and metastatic melanoma, and examined their association with clinical outcomes. Methods. Twenty-nine cases of primary esophageal (n = 19) and metastatic gastric and/or duodenal melanoma (n = 10) that were detected during upper GI endoscopy between 1995 and 2011 were retrospectively analyzed. Results. Three types of gross patterns were recognized-nodular pattern in 7 cases, mass-forming pattern in 18 cases, and flat pigmented pattern in 4 cases. In primary esophageal melanoma, 13 patients (68.4 %) underwent surgery and 9 received palliative therapy. Of all cases, 22 patients (75.9 %) died of disease progression; the median overall survival period was 12 months (interquartile range [IQR] 4.5-24.5 months), and from recognition of upper GI tract melanoma the median overall survival period was 9 months (IQR 3.5-17.0 months). In primary esophageal cases, skin melanoma stage better discriminated the patients with good prognosis than the esophageal cancer stage. The flat pigmented gross pattern proved to be a good prognostic factor in primary and metastatic GI tract melanomas (p = 0.016 and p = 0.046, respectively). Conclusions. Melanoma of the GI tract is a highly aggressive disease with a poor prognosis, both in primary and metastatic cases. However, in primary esophageal melanoma, careful inspection of the mucosa during endoscopic examination followed by surgical resection may result in extended survival.

AB - Background. Melanoma that involves the upper gastrointestinal (GI) tract is rare and studies relating to endoscopic and pathologic findings with clinical outcomes are lacking. We reviewed the gross and microscopic patterns of the upper GI tract in primary and metastatic melanoma, and examined their association with clinical outcomes. Methods. Twenty-nine cases of primary esophageal (n = 19) and metastatic gastric and/or duodenal melanoma (n = 10) that were detected during upper GI endoscopy between 1995 and 2011 were retrospectively analyzed. Results. Three types of gross patterns were recognized-nodular pattern in 7 cases, mass-forming pattern in 18 cases, and flat pigmented pattern in 4 cases. In primary esophageal melanoma, 13 patients (68.4 %) underwent surgery and 9 received palliative therapy. Of all cases, 22 patients (75.9 %) died of disease progression; the median overall survival period was 12 months (interquartile range [IQR] 4.5-24.5 months), and from recognition of upper GI tract melanoma the median overall survival period was 9 months (IQR 3.5-17.0 months). In primary esophageal cases, skin melanoma stage better discriminated the patients with good prognosis than the esophageal cancer stage. The flat pigmented gross pattern proved to be a good prognostic factor in primary and metastatic GI tract melanomas (p = 0.016 and p = 0.046, respectively). Conclusions. Melanoma of the GI tract is a highly aggressive disease with a poor prognosis, both in primary and metastatic cases. However, in primary esophageal melanoma, careful inspection of the mucosa during endoscopic examination followed by surgical resection may result in extended survival.

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DO - 10.1245/s10434-014-3637-2

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EP - 2539

JO - Annals of surgical oncology

JF - Annals of surgical oncology

SN - 1068-9265

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