{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T14:40:40Z","timestamp":1760280040691,"version":"build-2065373602"},"reference-count":29,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T00:00:00Z","timestamp":1647993600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Given equivocal results related to overall survival (OS) for patients with multiple primary melanomas (MPMs) compared with those with single primary melanomas (SPMs) in previous reports, the authors sought to determine whether OS differs between these 2 cohorts in their center using their UPCI\u201096\u201099 database. Secondary aims were to assess the differences in recurrence\u2010free survival (RFS). In a subset of patients, transcriptomic profiling of peripheral blood mononuclear cells (PBMCs) was performed to assess disease\u2010associated genes of interest.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective case\u2010controlled study included patients with MPMs and age\u2010, sex\u2010, and stage\u2010matched controls with SPMs at a 1:1 ratio. Cox regression models were used to evaluate the effect of the presence of MPMs on death and recurrence. NanoString PanCancer Immune Profiling was used to assess peripheral blood immune status in patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In total, 320 patients were evaluated. The mean patient age was 47\u00a0years; 43.8% were male. Patients with MPMs had worse RFS and OS (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.023 and <jats:italic>P<\/jats:italic>\u00a0=\u00a0.0019, respectively). The presence of MPMs was associated with an increased risk of death (hazard ratio [HR], 4.52, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.0006), and increased risk of disease recurrence (HR, 2.17; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.004) after adjusting for age, sex, and stage. The degree of tumor\u2010infiltrating lymphocytes (TILs) was different between the first melanoma of MPMs and SPMs. Expression of CXCL6 and FOXJ1 was increased in PBMCs isolated from patients with MPMs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with MPMs had worse RFS and OS compared with patients with SPMs. Immunologic differences were also observed, including TIL content and expression of CXCL6\/FOXJ1 in PBMCs of patients with MPMs, which warrant further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34169","type":"journal-article","created":{"date-parts":[[2022,3,23]],"date-time":"2022-03-23T09:16:26Z","timestamp":1648026986000},"page":"2098-2106","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Poorer survival outcomes in patients with multiple versus single primary melanoma"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8530-0907","authenticated-orcid":false,"given":"Lilit","family":"Karapetyan","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Hematology\/Oncology Hillman Cancer Center University of Pittsburgh Medical Center Pittsburgh Pennsylvania"},{"name":"Hillman Cancer Center University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9843-3925","authenticated-orcid":false,"given":"Xi","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of General Internal Medicine University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew D.","family":"Knight","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of General Internal Medicine University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziyu","family":"Huang","sequence":"additional","affiliation":[{"name":"Hillman Cancer Center Biostatistics Facility University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hong","family":"Wang","sequence":"additional","affiliation":[{"name":"Hillman Cancer Center University of Pittsburgh Medical Center Pittsburgh Pennsylvania"},{"name":"Hillman Cancer Center Biostatistics Facility University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cindy A.","family":"Sander","sequence":"additional","affiliation":[{"name":"Hillman Cancer Center University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher P.","family":"Minnier","sequence":"additional","affiliation":[{"name":"Hillman Cancer Center University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa","family":"Wilson","sequence":"additional","affiliation":[{"name":"Hillman Cancer Center University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aofei","family":"Li","sequence":"additional","affiliation":[{"name":"Hillman Cancer Center University of Pittsburgh Medical Center Pittsburgh Pennsylvania"},{"name":"Department of Pathology University of Pittsburgh Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arivarasan","family":"Karunamurthy","sequence":"additional","affiliation":[{"name":"Hillman Cancer Center University of Pittsburgh Medical Center Pittsburgh Pennsylvania"},{"name":"Department of Pathology University of Pittsburgh Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter J.","family":"Storkus","sequence":"additional","affiliation":[{"name":"Hillman Cancer Center University of Pittsburgh Medical Center Pittsburgh Pennsylvania"},{"name":"Department of Dermatology University of Pittsburgh Medical Center Pittsburgh Pennsylvania"},{"name":"Department of Immunology University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Kirkwood","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Hematology\/Oncology Hillman Cancer Center University of Pittsburgh Medical Center Pittsburgh Pennsylvania"},{"name":"Hillman Cancer Center University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,3,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.294.13.1647"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27407"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.33307"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.139.8.1013"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2019.1134"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.13144"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2013.4581"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2018.02.055"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hoc.2020.09.003"},{"key":"e_1_2_8_11_1","first-page":"6069","article-title":"Disease\u2010associated 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