Annals of Surgical Oncology

, Volume 21, Issue 8, pp 2532–2539 | Cite as

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 A. Kim
Thoracic Oncology

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.

Keywords

Melanoma Metastatic Melanoma Dacarbazine Tumor Thickness Invasion Depth 

Notes

Acknowledgment

This study was supported by the Proteogenomic Research Program through the National Research Foundation of Korea grant funded by the Korean Government (Ministry of Science, ICT and Future Planning).

Disclosure

There are no financial interests to report.

Supplementary material

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Supplementary Figure 1 (DOCX 401 kb)
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Supplementary Figure 2 (DOCX 471 kb)
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Supplementary Figure 3 (DOCX 52 kb)

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Copyright information

© Society of Surgical Oncology 2014

Authors and Affiliations

  • Ji Yong Ahn
    • 1
  • Hee Sang Hwang
    • 2
  • Young Soo Park
    • 2
  • Hyeong Ryul Kim
    • 3
  • Hwoon-Yong Jung
    • 1
  • Jin-Ho Kim
    • 1
  • Seung Eun Lee
    • 4
  • Min A. Kim
    • 5
  1. 1.Department of Gastroenterology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  2. 2.Department of Pathology, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  3. 3.Department of Thoracic Surgery, Asan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea
  4. 4.Department of Pathology, Samsung Medical CenterSungkyunkwan University School of MedicineSuwonKorea
  5. 5.Department of PathologySeoul National University College of MedicineSeoulKorea

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