Evaluation of metastatic malignant melanoma patients' clinical and pathological features, survival, and survival factors

Melanoma is an aggressive skin cancer originating from melanocytes. It is the fifth most common cancer in the world and its prevalence has been rising recently. Malignant melanomas are partially chemoresistant tumors with a high mortality rate, especially in the metastatic stage. However, there have been substantial improvements in melanoma treatment in recent years, particularly with the use of immune checkpoint inhibitors. In this study, we aimed to investigate the increased survival rate and prognostic indicators of survival in patients with metastatic malignant melanoma who were treated with current treatment regimens. 52 patients with metastatic cutaneous melanoma who were treated at the medical oncology department of the Hacettepe Oncology Hospital between 2014 and 2022 were included in our study. The patients' demographic data, clinical and pathological features, location of metastases, administered treatment, progression-free survival and overall survival rate were evaluated. 25% of the patients included in the study had de nova metastatic disease, and 75% of the patients had recurrent disease. Lung and distant lymph node metastasis were the most common first metastasis's locations of melanomas. The most preferred treatment regimen was immunotherapy agents given as monotherapy or in combination at all stages. Overall response rates (ORR) in patients receiving immunotherapy were 36% in primary line and 19% in secondary line. The median overall survival time was 20,9  2,19 months. 1, 3 and 5 year survival rates were found to be 78.1%, 29.7% and 25.5% respectively. There was a statistically significant relationship between overall survival time and tumor location, liver metastasis, bone metastasis, LDH level and NLR value. Liver metastasis was determined as an independent risk factor that negatively impacted overall survival in a multivariate analysis. Our findings were compared with a similar study previously conducted at our center. Our study supported the improvement in the survival of patients with metastatic melanoma, along with current treatment regimes.