Clinical characteristics and treatment outcomes of primary malignant melanoma of esophagus: a single center experience.

Abstract

BACKGROUND:

Primary malignant melanoma of esophagus (PMME) is an extremely rare disease with poor prognosis. We aimed to determine the clinical characteristics and treatment outcomes of patients with PMME.

METHODS:

We retrospectively reviewed 17 patients diagnosed with PMME in Samsung Medical Center between 2000 and 2020 with median 34 months of follow-up. Survival outcomes were analyzed with Kaplan-Meier method.

RESULTS:

15 patients (88.2%) were male and the most common presenting symptom was dysphagia (9/17, 52.9%). On endoscopy, tumors were mass-forming in 15 patients (88.2%) and diffusely infiltrative in two patients (11.8%). Lesions were melanotic in 13 patients (76.5%) and amelanotic in four patients (23.5%). The most common tumor location was lower esophagus (11/17, 64.7%). The disease was metastatic at the time of diagnosis in four patients (23.5%). As for treatment, 10 patients (58.8%) underwent surgery. In all 17 patients, the median overall survival was 10 months. In surgically treated patients, all patients experienced recurrence and the median disease-free survival was 4 months. There was no statistical difference in overall survival between patients with or without surgery. Patients with diffusely infiltrative tumor morphology had better overall survival compared to those with mass-forming tumor morphology (P = 0.048). Two patients who received immunotherapy as the first-line treatment without surgery showed overall survival of 34 and 18 months, respectively.

CONCLUSIONS:

As radical resection for patients with PMME does not guarantee favorable treatment outcomes, novel treatment strategy is required. Further large-scale studies are warranted to determine the efficacy of immunotherapy for patients with PMME.

• Authors: Tae-Se Kim, Byung-Hoon Min, Yang Won Min, Hyuk Lee, Poong-Lyul Rhee, Jae J Kim, Jun Haeng Lee
• Journal: BMC gastroenterology (BMC Gastroenterol) Vol. 22 Issue 1 Pg. 157 (Mar 29 2022) ISSN: 1471-230X [Electronic] England
• PMID: 35351022 (Publication Type: Journal Article)
• Copyright: © 2022. The Author(s).

Topics

• Esophagus (pathology)
• Humans
• Male
• Melanoma (diagnosis, pathology, therapy)
• Retrospective Studies
• Skin Neoplasms
• Treatment Outcome