{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:24:30Z","timestamp":1785410670032,"version":"3.56.0"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2006,3,27]],"date-time":"2006-03-27T00:00:00Z","timestamp":1143417600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2006,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>The natural history of metastatic melanoma in lymph nodes in the absence of a known primary site (MUP) has been defined poorly; thus, treatment guidelines for patients with MUP are not clear\u2010cut.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors conducted a retrospective analysis of consecutive patients with melanoma (from 1990 to 2001) who underwent surgical resection for melanoma metastatic to regional lymph nodes. Among those patients, 71 patients with MUP and 466 control patients who had regional lymph node metastases of similar stage with a known primary site were identified. Associations between clinicopathologic factors and survival were estimated by using the Cox proportional hazards model.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>After they underwent lymph node dissection, patients with MUP were classified with N1b disease (47%), N2b disease (14%), or N3 disease (39%). With a median follow\u2010up of 7.7 years, the 5\u2010year and 10\u2010year overall survival rates were 55% and 44%, respectively, for patients with MUP, compared with 42% and 32%, respectively, for the control group (<jats:italic>P<\/jats:italic> = .04). In multivariate analyses, age 50 years or older, male gender, and N2b or N3 disease status were identified as adverse prognostic factors, and MUP was identified as a favorable prognostic factor (hazard ratio, 0.61; 95% confidence interval, 0.42\u20130.86; <jats:italic>P<\/jats:italic> = .006) for overall survival.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The relatively favorable long\u2010term survival of patients with MUP in the current study suggested that patients with MUP have a natural history that is similar to (if not better than) the survival of many patients with Stage III disease. Therefore, patients with MUP should be treated with an aggressive surgical approach with curative intent and should be considered for Stage III adjuvant therapy protocols. Cancer 2006. \u00a9 2006 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.21835","type":"journal-article","created":{"date-parts":[[2006,3,27]],"date-time":"2006-03-27T18:16:55Z","timestamp":1143483415000},"page":"2012-2020","source":"Crossref","is-referenced-by-count":96,"title":["Metastatic melanoma to lymph nodes in patients with unknown primary sites"],"prefix":"10.1002","volume":"106","author":[{"given":"Janice N.","family":"Cormier","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Xing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuelin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latunya","family":"Davidson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey E.","family":"Gershenwald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey E.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul F.","family":"Mansfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merrick I.","family":"Ross","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2006,3,27]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-195212000-00001"},{"key":"e_1_2_6_3_2","first-page":"341","article-title":"Malignant melanoma of unknown primary origin","volume":"117","author":"DasGupta T","year":"1963","journal-title":"Surg Gynecol Obstet."},{"key":"e_1_2_6_4_2","first-page":"400","article-title":"Patient characteristics, treatment, and outcome of unknown primary melanoma in the United States for the years 1981 and 1987","volume":"62","author":"Sutherland CM","year":"1996","journal-title":"Am Surg."},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-198001000-00018"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.2930190308"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19970501)79:9<1816::AID-CNCR26>3.0.CO;2-#"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1975.01360140040008"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800641114"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19820315)49:6<1106::AID-CNCR2820490607>3.0.CO;2-0"},{"key":"e_1_2_6_11_2","first-page":"335","article-title":"Metastatic malignant melanoma with an unknown primary","volume":"156","author":"Reintgen DS","year":"1983","journal-title":"Surg Gynecol Obstet."},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1987.01400240026003"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19911215)68:12<2579::AID-CNCR2820681209>3.0.CO;2-G"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.2930230104"},{"key":"e_1_2_6_15_2","first-page":"442","article-title":"Melanoma from unknown primary site and amelanotic melanoma","volume":"9","author":"Giuliano AE","year":"1982","journal-title":"Semin Oncol."},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/00008390-200502000-00013"},{"key":"e_1_2_6_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20099"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19970701)80:1<60::AID-CNCR8>3.0.CO;2-J"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000637-199201000-00021"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199410000-00002"},{"key":"e_1_2_6_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/b97251_24"},{"key":"e_1_2_6_22_2","doi-asserted-by":"publisher","DOI":"10.1080\/01621459.1958.10501452"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.2517-6161.1972.tb00899.x"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4757-3294-8"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(196511)18:11<1399::AID-CNCR2820181104>3.0.CO;2-R"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.21835","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.21835","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T11:27:16Z","timestamp":1760268436000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.21835"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,3,27]]},"references-count":24,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2006,5]]}},"alternative-id":["10.1002\/cncr.21835"],"URL":"https:\/\/doi.org\/10.1002\/cncr.21835","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,3,27]]}}}