Table 2 Patient and therapy parameter, tumor characteristics, and follow-up data
Patient 1 | Patient 2 | Patient 3 | Patient 4 | Patient 5 | Patient 6 | |
|---|---|---|---|---|---|---|
Age (years) | 66 | 63 | 54 | 67 | 73 | 68 |
Gender | Male | Male | Female | Female | Female | Female |
Diagnosis before abdominoperineal resection | ||||||
S100 protein in serum (normal range < 0.1 μg/l) | 0.079 | 0.301 | 0.049 | 0.199 | 0.039 | 0.050 |
Preoperative biopsy | – | Yes | – | Yes | – | Yes |
Previous local excision | Yes | – | Yes | – | Yes | |
Therapy | ||||||
Type of abdominoperineal resection (APR) | APR | ELAPR | ELAPR | ELAPR | lap. ELAPR | lap. ELAPR |
Intention for abdominoperineal resection | Curative | Palliative | Curative | Palliative | Palliative | Curative |
Time interval between diagnosis and APR (months) | 3 | 1 | 3 | 2 | 13 | 2 |
Adjuvant/additive therapy | – | DTIC | 1. Ipilimumab | DTIC | 1. Radiation | Ipilimumab (1 cycle) |
2. Nivolumab | 2. DTIC | |||||
3. Ipilimumab | ||||||
Tumor characteristics, histopathology/immunostaining | ||||||
Tumor stage | I | IV | II | IV | III | III |
Tumor localization referring to the dentate line | Above DL | Overlapping zones | On and above DL (multifocal) | DL | DL | Above DL |
Tumor diameter (cm) | 0.9 | 11 | 0.5 + 0.4 + 0.4 | 10.5 | <1 | 10,9 |
Depth of infiltration (mm) | <3 | 15 | 4 | All layers | 3 | All layers |
Negative resection margin (R0) | Yes | Yes (<1 mm) | Yes | Yes | Yes (marginal) | Yes |
Amelanotic melanoma | Yes | No | No | Yes | No | No |
S100 protein | – | – | – | Positive | – | Positive |
Melan-A | – | Positive | – | Positive | – | Positive |
Mutation analysis | ||||||
KIT | – | Wild–type | Wild–type | Wild–type | Wild–type | Wild–type |
BRAF | – | – | Wild–type | Wild–type | Wild–type | Wild–type |
NRAS | – | – | Wild–type | Wild–type | – | Wild–type |
Follow up (months) | 102 | 6 | 60 | 10 | 18 | 18 |
Local recurrence | No | Yes | No | No | Yes | No |
Time interval to abdominoperineal resection (months) | – | 1 | – | – | 3 | – |
Metachronous lymph node metastasis | No | ns | Yes | Yes | Yes | No |
Mediastinum | – | – | Yes | Yes | – | – |
Perirectal | – | – | – | – | yes | – |
Time interval to abdominoperineal resection (months) | – | – | 42 | 3 | 5 | – |
Metachronous distant metastasis | No | ns | Yes | Yes | Yes | No |
Lung/pleura | – | ns | Yes | – | Yes | No |
Liver | – | – | No | Yes | Yes | No |
Peritoneum | – | ns | No | No | Yes | No |
Bone | – | ns | No | No | Yes | No |
Soft tissue | – | ns | No | No | Yes | No |
Brain | – | ns | No | No | Yes | No |
Time interval to abdominoperineal resection (months) | – | – | 21 | 3 | 12 | – |
Health status at follow-up time interval to abdominoperineal resection (months) | Disease-free | Dead 6 | Slowly progressive disease | Dead 10 | Dead 18 | Disease-free |