scholarly journals Bone-Specific Metastasis Pattern of Advanced-Stage Lung Adenocarcinoma According to the Localization of the Primary Tumor

2021 ◽  
Vol 27 ◽  
Author(s):  
Peter Radeczky ◽  
Judit Moldvay ◽  
Janos Fillinger ◽  
Beata Szeitz ◽  
Bence Ferencz ◽  
...  
Keyword(s):  
Lung Adenocarcinoma ◽  
Primary Tumor ◽  
Cox Regression ◽  
Distant Metastases ◽  
Tumor Location ◽  
Skeletal Metastases ◽  
Advanced Stage ◽  
Primary Tumors ◽  
Cox Regression Analysis ◽  
Primary Tumor Location

Background: Patients with advanced-stage lung adenocarcinoma (LADC) often develop distant metastases in the skeletal system. Yet, the bone-specific metastasis pattern is still controversial. We, therefore, aimed to examine how the primary tumor location affects bone specificity and survival in LADC patients diagnosed with skeletal metastases.Methods: In total, 209 bone-metastatic Caucasian LADC patients from two thoracic centers were included in this study. Focusing on the specific location of primary tumors and bone metastatic sites, clinicopathological variables were included in a common database and analyzed retrospectively. Skeletal metastases were diagnosed according to the contemporary diagnostic guidelines and confirmed by bone scintigraphy. Besides region- and side-specific localization, primary tumors were also classified as central or peripheral tumors based on their bronchoscopic visibility.Results: The most common sites for metastasis were the spine (n = 103) and the ribs (n = 60), followed by the pelvis (n = 36) and the femur (n = 22). Importantly, femoral (p = 0.022) and rib (p = 0.012) metastases were more frequently associated with peripheral tumors, whereas centrally located LADCs were associated with humeral metastases (p = 0.018). Moreover, we deduced that left-sided tumors give rise to skull metastases more often than right-sided primary tumors (p = 0.018). Of note, however, the localization of the primary tumor did not significantly influence the type of affected bones. Multivariate Cox regression analysis adjusted for clinical parameters demonstrated that central localization of the primary tumor was an independent negative prognostic factor for overall survival (OS). Additionally, as expected, both chemotherapy and bisphosphonate therapy conferred a significant benefit for OS.Conclusion: The present study demonstrates unique bone-specific metastasis patterns concerning primary tumor location. Peripherally located LADCs are associated with rib and femoral metastases and improved survival outcomes. Our findings might contribute to the development of individualized follow‐up strategies in bone-metastatic LADC patients and warrant further clinical investigations on a larger sample size.

Differences in systemic and surgical therapy between right (R) and left (L) sided metastatic colorectal cancer (mCRC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 3602-3602
Author(s):  
Hagen F. Kennecke ◽  
Yaling Yin ◽  
Jonathan M. Loree ◽  
Rachel Leung ◽  
Sharlene Gill
Keyword(s):  
Surgical Therapy ◽  
Systemic Therapy ◽  
Cox Regression ◽  
Growth Factor Receptor ◽  
Distant Metastases ◽  
Tumor Grade ◽  
Tumor Location ◽  
Primary Tumors ◽  
Similar Frequency ◽  
Cox Regression Analysis

3602 Background: Patients (pts) with L sided primary tumors and mCRC have a significantly longer overall survival (mOS) than R sided tumors. Reasons for this remain unclear. The objective of this study was to compare systemic and surgical therapy received by tumor side and correlate this with mOS. Methods: Sequential pts with mCRC referred to the British Columbia Cancer Agency in 4 treatment eras were included. Pts with unresected primary tumors were excluded to ensure accurate ascertainment of tumor location. Receipt of systemic therapy includes Òall 3 drugsÓ (irinotecan, oxaliplatin, fluouracil), bevacizumab and epidermal growth factor receptor inhibitors (EGFRi). Cox-regression survival analysis for sidedness was performed controlling for age, sex, tumor grade, lymphovascular/perineural invasion, nodes removed and metastatectomy. Results: Among 3242 pts, a progressive improvement in mOS is documented in both L and R sided tumors since 1995. L and R tumors received Òall 3 drugsÓ, bevacizumab and EGFRi therapy with similar frequency which plateaued after the introduction of EGFRiÕs in 2009. Patients with L sided tumors were significantly more likely to have a hepatic or pulmonary resection. In Cox regression analysis, the mOS difference between L and R sided tumors was more pronounced in more recent eras. Conclusions: Patients with R sided tumors receive similar systemic therapy compared to L sided tumors, but are significantly less likely to undergo resection of distant disease. Resection of distant metastases may be an important consideration to understand the survival differences between R vs L mCRC. [Table: see text]

scholarly journals Primary tumor location affects recurrence-free survival for patients with colorectal liver metastases after hepatectomy: A propensity score matching analysis

2020 ◽  
Author(s):  
Yuanping Zhang ◽  
Yongjin Wang ◽  
Yichuan Yuan ◽  
Jiliang Qiu ◽  
Yuxiong Qiu ◽  
...  
Keyword(s):  
Propensity Score ◽  
Liver Metastases ◽  
Primary Tumor ◽  
Colorectal Liver Metastases ◽  
Tumor Location ◽  
Recurrence Free Survival ◽  
Primary Tumors ◽  
Free Survival ◽  
Primary Tumor Location ◽  
Before And After

Abstract Background: Whether primary tumor location of colorectal cancer (CRC) affects survival of patients after resection of liver metastases remains controversial. This study was conducted to investigate the differences in clinicopathological characteristics and prognosis between right-sided CRC and left-sided CRC patients with liver metastases after hepatectomy. Methods: From 2002 to 2018, 611 patients with colorectal liver metastases (CRLM) who underwent hepatectomy at our center were reviewed. Primary tumors located from cecum to transverse colon were defined as right-sided group (n = 141); tumors located from splenic flexure to rectum were defined as left-sided group (n = 470). Patients were compared between two groups before and after a 1:1 propensity score matching (PSM) analysis. Results: Before PSM, median survival time and 5-year overall survival (OS) rate in right-sided group were 77 months and 56.3%, and those in left-sided group were 64 months and 51.1%, respectively. After PSM, median survival time and 5-year OS rate in right-sided group were 77 months and 55.9%, and those in left-sided group were 58.8 months and 47.3%, respectively. The OS rates did not differ between two groups before and after PSM (P = 0.575; P = 0.453). However, significant different recurrence-free survival (RFS) rate was found before and after PSM between right-sided and left-sided group (P = 0.028, P = 0.003). Conclusions: Compared to patients with left-sided primary tumors, patients with right-sided primary tumors had a worse RFS but similar OS. Careful preoperative evaluation, intensive preoperative chemotherapy and frequent follow-up to detect early recurrence might be justified for CRLM patients with right-sided primary tumors.

scholarly journals An evaluation of the role of tumor load in cytoreductive nephrectomy

2020 ◽  
Vol 14 (12) ◽  
Author(s):  
Andrew W. Silagy ◽  
Cihan Duzgol ◽  
Julian Marcon ◽  
Renzo G. DiNatale ◽  
Roy Mano ◽  
...  
Keyword(s):  
Primary Tumor ◽  
Tumor Volume ◽  
Cox Regression ◽  
Three Dimensional ◽  
Volumetric Analysis ◽  
Cytoreductive Nephrectomy ◽  
Primary Tumors ◽  
Cox Regression Analysis ◽  
Entire Cohort ◽  
Primary Tumor Volume

Introduction: New radiological tools can accurately provide preoperative three-dimensional spatial assessment of metastatic renal cell carcinoma (RCC) We aimed to determine whether the distribution, volume, shape, and fraction of RCC resected in a cytoreductive nephrectomy associates with survival. Methods: We retrospectively reviewed 560 patients undergoing cytoreductive nephrectomy performing a comprehensive volumetric analysis in eligible patients of all detectable primary and metastatic RCC prior to surgery. We used Cox regression analysis to determine the association between the volume, shape, fraction resected, and distribution of RCC and overall survival (OS). Results: There were 62 patients eligible for volumetric analysis, with similar baseline characteristics to the entire cohort, and median survivor followup was 34 months. Larger primary tumors were less spherical, but not associated with different metastatic patterns. Increased primary tumor volume and tumor size, but not the fraction of tumor resected, were associated with inferior survival. The rank of tumors based on unidimensional size did not completely correspond to the rank by primary tumor volume, however, both measurements yielded similar concordance for predicted OS. Larger tumor volume was not associated with a longer postoperative time off treatment. Conclusions: Primary tumor volume was significant for predicting OS, while the fraction of disease resected did not appear to impact upon patient outcomes. Although rich in detail, our study is potentially limited by selection bias. Future temporal studies may help elucidate whether the primary tumor shape is associated with tumor growth kinetics.

Prognostic impact of PD-L1 and PD-1 expression by primary tumor location in colorectal cancer.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 628-628 ◽  
Author(s):  
Jonna Berntsson ◽  
Anna Larsson ◽  
Bjorn Nodin ◽  
Jakob Eberhard ◽  
Karin Jirstrom
Keyword(s):  
Colorectal Cancer ◽  
Immune Cells ◽  
Primary Tumor ◽  
Tumor Location ◽  
Left Colon ◽  
Prognostic Impact ◽  
Full Cohort ◽  
Primary Tumors ◽  
Primary Tumor Location ◽  
Entire Cohort

628 Background: A plethora of studies report abundant expression of programmed death-ligand 1 (PD-L1) on tumors to be associated with poor outcome in several cancer forms, whereas immune cell-specific expression of PD-L1 has been associated with improved prognosis in colorectal cancer. However, none of these studies have investigated the association with prognosis according to primary tumor location. This study aimed to investigate the clinicopathological correlates and prognostic impact of PD-L1 and its receptor PD-1 in colorectal cancer, with particular reference to the anatomical subsite of the primary tumor. Methods: Immunohistochemical expression of PD-L1 and PD-1 was analysed in tissue microarrays with tumors from 557 incident cases of CRC from a prospective population-based cohort. Kaplan-Meier and Cox regression analyses were applied to determine the impact of biomarker expression on 5-year overall survival (OS), in the entire cohort and in subgroup analysis of right colon, left colon, and rectum. Results: High PD-L1 expression on tumor-infiltrating immune cells correlated significantly with an improved 5-year OS in univariable and multivariable analysis, adjusted for age, sex, TNM stage, differentiation grade, and vascular invasion, in the full cohort (HR = 0.49; 95 % CI 0.35-0.68), and in primary tumors of the right (HR = 0.43; 95 % CI 0.25-0.74) and the left colon (HR = 0.28; 95 % CI 0.13-0.61), but not in rectal cancer. High tumor-specific PD-L1-expression was not significantly associated with prognosis in neither the full cohort nor according to primary tumor location. High expression of PD-1 on tumor-infiltrating immune cells was significantly associated with an improved 5-year overall survival in the entire cohort (HR = 0.42; 95 % CI 0.21-0.87), but not in subsite analysis according to primary tumor location. Conclusions: This study is, to the best of our knowledge, the first to investigate the prognostic impact of PD-L1 and PD-1 expression according to primary tumor site in colorectal cancer. Dense infiltration of PD-L1+ immune cells was found to be an independent favorable prognostic factor in primary tumors of the right and left colon, but not in the rectum.

The prognostic significance of extra-intestinal tumor location for primary nonmetastatic gastrointestinal stromal tumors.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 2-2
Author(s):  
Mary Lydon Guye ◽  
Rebecca A. Nelson ◽  
Amanda Kathleen Arrington ◽  
Steven L. Chen ◽  
Warren Allen Chow ◽  
...  
Keyword(s):  
Overall Survival ◽  
Tumor Size ◽  
Primary Tumor ◽  
Gastrointestinal Stromal Tumors ◽  
Tumor Location ◽  
Gi Tract ◽  
Primary Tumors ◽  
Primary Tumor Location ◽  
Stromal Tumors ◽  
Mesenchymal Neoplasm

2 Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm of the GI tract. Tumor size, tumor location, and mitotic index are established factors that risk stratify recurrence and survival. Extra-intestinal GISTs are infrequently observed and our objective was to investigate the outcomes of patients with primary GISTs found outside the GI tract. Methods: The Surveillance Epidemiology and End Results registry was used to identify patients with GIST treated with surgery between 1996 and 2008. Patients were evaluated by standard clinical and pathological indices including: age, primary tumor location (extra−intestinal vs. GI tract), tumor size, tumor grade, and extent of disease. Overall survival differences between primary site groups were assessed by Kaplan-Meier method. Univariate and stepwise multivariate Cox proportional hazards analyses were performed. Results: Of the 2812 patients with surgically treated GIST, 2489 (88.5%) had a primary tumor location in the GI tract and 323 (11.5%) were located in extra-intestinal sites. Comparison of patients by primary tumor location demonstrated more locally advanced cancers with lymph node involvement (40.2% vs. 18.4%; p<.0001) and a higher occurrence of distant metastatic disease (22.3% vs. 16.6%; p<.0001) among the extra-intestinal GISTs. When comparing overall survival, patients with extra-intestinal GISTs had significantly worse 5 year survival (62% vs. 70%, respectively; p=0.002) than patients with primary tumors within the GI tract. Stepwise multivariate analysis showed that non-intestinal site was an independent predictor of poorer survival (HR 1.29, 95% CI [1.05-1.59], p=0.015). Conclusions: Our data indicates that extra-intestinal location for primary non-metastatic GIST is an independent poor prognostic factor, with worse overall survival, compared to GISTs located within the GI tract. Risk stratification for prognosis should account for these rare GIST locations.

Prognostic impact of primary tumor location in advanced urothelial carcinoma: The EORTC series.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e16034-e16034
Author(s):  
Marco Moschini ◽  
Shahrokh F. Shariat ◽  
Maria De Santis ◽  
Joaquim Bellmunt ◽  
Cora N. Sternberg ◽  
...  
Keyword(s):  
Primary Tumor ◽  
Performance Status ◽  
Distant Metastases ◽  
Tumor Location ◽  
Upper Urinary Tract ◽  
High Dose ◽  
Significant Heterogeneity ◽  
Prognostic Impact ◽  
Primary Tumor Location ◽  
Cox Proportional Hazard Regression

e16034 Background: The prognostic relevance of the primary location of urothelial cell carcinoma (UCC) on outcomes is poorly documented. This parameter has been studied in 3 EORTC trials in advanced UCC that included patients with different initial primary tumor locations. Methods: We used the data prospectively collected in three EORTC advanced UCC studies 30924 (M-VAC versus High dose M-VAC), 30986 (MCAVI versus GC, among patients unfit for CDDP), 30987 (GC-Paclitaxel versus GC, among patients fit for CDDP). Ineligible patients and other tumor locations were excluded. Patients all had measureable distant metastases or unresectable UCC and WHO performance status 0-2. Patients were grouped by primary tumor location as bladder (BCa) versus upper urinary tract (UTUC). PFS and OS by tumor location was tested in Cox proportional hazard regression stratified by study and treatment using at 2-sided α of 0.05. Results: Of the 1,039 patients, 85.3% and 14.7% patients had BCa and UTUC, respectively. Patient and disease characteristics (Table) suggested better performance status and slightly more males among patients with GCa. With a median follow up of 4.8 years (IQR:4.0-6.7), 733 deaths were recorded and 925 had progressed or died. OS and PFS did not differ significantly by tumor location overall (P=0.317 and P=0.685 respectively, Table 1), but there is significant heterogeneity across treatments (heterogeneity P=0.0450 for OS and P=0.0121 for PFS) with a suggestion of differential results in the M-CAVI arm for unfit patients. Conclusions: Primary UTUC location is uncommon in advanced UCC and did not seem to markedly impact PFS or OS. However, the findings may vary according to treatment. [Table: see text]

748 Myeloid cell infiltration correlates with prognosis and varies based on tumor location in cholangiocarcinoma

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A796-A797
Author(s):  
Paul Kunk ◽  
Sean Dougherty
Keyword(s):  
Primary Tumor ◽  
Myeloid Cells ◽  
Tumor Location ◽  
P Value ◽  
M2 Macrophages ◽  
Primary Tumors ◽  
Primary Tumor Location ◽  
Metastatic Lesions ◽  
Higher Power ◽  
Mesothelin Expression

BackgroundCholangiocarcinoma (CC) is a rare malignancy with an increasing incidence and poor prognosis. Immunotherapy represents one potential treatment for CC, however identification of immunotherapeutic targets requires a thorough characterization of the tumor immune microenvironment (TIME). Mesothelin, a tumor associated antigen, is abundantly expressed in other malignancies, though its expression in CC has not been well characterized. We hypothesized that (1) the TIME of CC would vary by primary tumor location and between primary and metastatic lesions, (2) high tumor infiltration by CD8+ T cells and low infiltration by M2 macrophages would be associated with improved survival, and (3) most CC would express mesothelin.Methods99 CC tumors from unique stage I-IV patients were included, of which 89 were primary tumors (24 intrahepatic (ICC), 65 extrahepatic (ECC - 30 hilar (H-ECC) and 35 distal (D-ECC))) and 10 were metastatic lesions. Tissue microarrays were constructed and immunohistochemistry (IHC) was performed for lymphoid and myeloid markers, as well as for PD-L1 and mesothelin. IHC+ cells were quantified by automated image analysis. Expression of mesothelin and PD-L1 by tumors cells were evaluated on a semiquantitative scale (0, +1, +2, or +3). Hypothesis testing was performed using Kruskal-Wallis test and survival analyses were performed with Univariate and Multivariate Cox Hazard Models.ResultsMost tumors were infiltrated by myeloid cells in addition to CD4+, CD8+, and FoxP3+ T-cells. Mesothelin was expressed (≥1+) in 68% of tumors (figure 1), while PD-L1 was expressed (≥1%) in only 16% of tumors. Higher densities of M1 macrophages (CD68+) were present in D-ECC relative to ICC and H-ECC (figure 2). M1 macropahges were also found in higher densities in metastatic tumors. Mesothelin and granzyme-B expression was significantly higher in D-ECC. Increasing density of myeloid cells (CD14+) and M2 macrophages (CD163+) was associated with worse survival (p= 0.02, 0.03, respectively) (figure 3). Intraepithelial and intratumoral T cell infiltration did not correlate with OS.Abstract 748 Figure 1Mesothelin expression by primary tumor locationA+C) Representative low Mesothelin expression at low (X10) (A) and higher power (X20) (C). B+D) Representative high Mesothelin expression at low (X10)(B) and higher power (X20)(D). E) Log(x+1) transformed Mesothelin Expression as determined by automated cell counting, median and IQR, all data points shown. Median: 5.5, 79.5, 146.0 for ICC, H-ECC, D-ECC, respective, p-value = 0.025. F-H) Mesothelin Expression determined by visual inspection and scoring for ICC (F), H-ICC (G), and D-ECC (D).Abstract 748 Figure 2Immune infiltration based on primary tumor locationIncrease in immune infiltrate in primary tumors as distance from liver increases. P-values determined by Jonckheere-Terpstra Test with FDR correctionsAbstract 748 Figure 3CD14 and CD163 Correlate with OSA+C) Kaplan Meier Curve of OS for (A) CD14 (Median OS: 20 vs. 90 months, log-rank p-value <0.01) and (C) CD163 (Median OS: 15 vs. 32 months, log-rank p-value<0.01). B+D) Multivariate Cox Hazard Models. Assumptions of Cox Hazard Model were checked with Schoenfeld residual values, significance level <0.01ConclusionsThe TIME of CC varies significantly by primary tumor location and between primary and metastatic lesions. D-ECC has a favorable immune profile compared to ICC and H-ECC, with a better milieu for antigen presentation including increased mesothelin and less suppressive macrophages, which may support better response to checkpoint blockade. The data supported the hypothesis that higher densities of intra-tumoral M2 macrophages and myeloid cells correlated with worse OS, even after controlling for clinical variables, suggesting that these cell populations may represent promising immunotherapeutic targets in CC.

Primary tumor location as a prognostic and predictive factor in metastatic colorectal cancer (mCRC) treated with chemotherapy plus cetuximab: A retrospective analysis.

2017 ◽  
Vol 35 (4_suppl) ◽  
pp. 711-711 ◽  
Author(s):  
Tamotsu Sagawa ◽  
Kyoko Hamaguchi ◽  
Akira Sakurada ◽  
Fumito Tamura ◽  
Tsuyoshi Hayashi ◽  
...  
Keyword(s):  
Primary Tumor ◽  
Strong Predictor ◽  
Tumor Location ◽  
Molecular Characteristics ◽  
Survival Times ◽  
Retrospective Case ◽  
Primary Tumors ◽  
Primary Tumor Location ◽  
Left And Right ◽  
The Impact

711 Background: Left- and right-sided colon cancers are significantly different in epidemiologic, clinicopathological and molecular characteristics. However, the impact of primary tumor location in mCRC treated biological targeted agent in combination with chemotherapy is unclear. We therefore investigated the prognostic and predictive impact of primary tumor location in mCRC. Methods: Single-institution, retrospective, case-control study was reviewed. A total of 96 patients with mCRC were enrolled between January 2011 and December 2015. We evaluated the association between tumor location and survival parameters in patients with previously untreated mCRC receiving first-line chemotherapy plus cetuximab or bevacizumab. The impact of primary tumor location for cetuximab and bevacizumab groups was analyzed, respectively. Left-sided primary tumors were defined as tumors from rectum to splenic flexure, while right-sided primary tumors were defined as tumors from cecum to the distal part of the transverse colon. Results: 68 patients presented left-sided tumors and 28 patients right-sided primary tumors. In the cetuximab group, left-sided tumors were significantly superior to right-sided tumors in terms of the progression-free survival (PFS) and Overall survival (OS) (PFS, left vs right, 18.3 vs 6.8 M, p = 0.0415; OS, 50.6 vs10.5 M, p = 0.0004). Likewise, in the bevacizumab group, OS showed differences between the left- and right-sided tumors (PFS, left vs right, 11.6 vs 7.3 M, p = 0.1904; OS, 25.7 vs 16.2 M, p = 0.0389). In left-sided tumors, cetuximab group were significantly superior to bevacizumab group in terms of the OS (PFS, cetuximab vs bevacizumab, 18.0 vs 11.6 M, p = 0.1088; OS, 50.6 vs 25.7 m p = 0.0354). Conversely, in right-sided, the survival times showed no differences between cetuximab- and bevacizumab group (PFS, cetuximab vs bevacizumab, 6.8 vs 7.3 M, p = 0.7816; OS, 10.5 vs 16.2 M, p = 0.1088). Conclusions: Our study demonstrates that primary tumor location is an important prognostic factor in previously untreated mCRC. Furthermore, left-sided primary tumor location might be a strong predictor of PFS and OS in cetuximab therapy.

Melanoma of the Nail Apparatus: An Analysis of Patients’ Survival and Associated Factors

Dermatology ◽  
2021 ◽  
pp. 1-5
Author(s):  
S. Morteza Seyed Jafari ◽  
Sven Lieberherr ◽  
Simone Cazzaniga ◽  
Helmut Beltraminelli ◽  
Eckart Haneke ◽  
...  
Keyword(s):  
Overall Survival ◽  
Skin Graft ◽  
Primary Tumor ◽  
Distant Metastases ◽  
Tumor Location ◽  
Full Thickness ◽  
Full Thickness Skin Graft ◽  
Primary Tumor Location ◽  
Thickness Skin ◽  
Disease Free

<b><i>Background:</i></b> There are no proper management guidelines for nail apparatus melanoma (NAM). <b><i>Objective:</i></b> This study aimed to describe the clinical features, the presence of locoregional and distant metastases and disease-free and overall survival of NAM treated at our institution. <b><i>Methods:</i></b> A retrospective cohort review of patients with single, primary localized histopathologically confirmed NAM was performed. Collected data consisted of patients’ characteristics and tumor features. In addition, local recurrence, locoregional metastases, distant metastases, disease-free survival (DFS) and overall survival (OS) were used as the main outcomes in our analysis. <b><i>Results:</i></b> Thirty patients with NAM were included. The overall survival (OS) in our patients at 5 and 10 years was 85.6 and 73.4%, respectively. DFS was significantly higher in patients with primary tumor location in the hand and without tumor-infiltrating lymphocytes (<i>p</i> value = 0.01 and 0.04, respectively). The patients with in situ melanoma or Breslow thickness &#x3c;1 mm had a significantly higher chance of DFS and OS (90.0 and 94.1% at 5 years, respectively) than those with thicker NAM (58.3 and 55.6% at 5 years, respectively). A total of 53.3% of 30 patients underwent primary excision and covering with a full-thickness skin graft, while 13.3% of our 30 patients underwent digit amputation. The patients who underwent excision and covering with a full-thickness skin graft showed a complete overall survival (100% at 5 years). <b><i>Conclusion:</i></b> Primary tumor location in the hand and lower tumor thickness might be correlated with better patients’ survival. The study results suggest that total amputation might not be necessary in all NAM cases.

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