{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T16:48:30Z","timestamp":1784825310825,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2022,4,25]],"date-time":"2022-04-25T00:00:00Z","timestamp":1650844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","award":["A27412"],"award-info":[{"award-number":["A27412"]}],"id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Based on molecular evidence that melanomas with unknown primary (MUPs) arise from the skin, we hypothesised that sites of MUPs are disproportionately on trunk and lower limbs, sites that are not readily visible to patients and clinicians. We tested this hypothesis by inferring the anatomic site of origin of MUPs from the corresponding known cutaneous sites of melanoma patients with known primary tumours (MKPs). We analysed data from three separate cohorts of patients from Brisbane, Australia (n\u00a0=\u00a0236); Manchester, UK (n\u00a0=\u00a051) and Padova, Italy (n\u00a0=\u00a033), respectively, who first presented with stage III melanoma with lymph node metastases. We matched two MKP patients to each MUP patient based on lymph node dissection (LND) site, age and sex, and imputed cutaneous sites of origin of MUPs from their two matched MKPs for study countries, giving two possible sites for each MUP per centre. Overall, results showed that MUP patients were predominantly male, and trunk was the most likely origin, comprising around a third to a half of MUPs across the three cohorts. The remaining MUP inferred sites varied by country. In the Australian cohort, the legs accounted for a third of imputed sites of MUPs, while in the UK and Italian cohorts, the most frequent site was the arms followed by the legs. Our findings suggest the need for regular and thorough skin examination on trunk and limbs, especially in males, to improve early detection of cutaneous melanoma and reduce the risk of metastatic disease at the time of presentation.<\/jats:p>","DOI":"10.1002\/ijc.34020","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T10:51:15Z","timestamp":1649674275000},"page":"396-401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hypothesised cutaneous sites of origin of stage <scp>III<\/scp> melanomas with unknown primary: A multicentre study"],"prefix":"10.1002","volume":"151","author":[{"given":"Bethan","family":"Clayton","sequence":"first","affiliation":[{"name":"Department of Surgery The Christie NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferhan","family":"Muneeb","sequence":"additional","affiliation":[{"name":"Department of Surgery The Christie NHS Foundation Trust  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Celia B.","family":"Hughes","sequence":"additional","affiliation":[{"name":"Population Health Department QIMR Berghofer Medical Research Institute  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5102-4120","authenticated-orcid":false,"given":"Megan E.","family":"Grant","sequence":"additional","affiliation":[{"name":"Molecular Oncology Group CRUK Manchester Institute, University of Manchester  Manchester UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6406-4076","authenticated-orcid":false,"given":"Kiarash","family":"Khosrotehrani","sequence":"additional","affiliation":[{"name":"Experimental Dermatology Group The University of Queensland Diamantina Institute, Translational Research Institute  Brisbane Australia"},{"name":"Department of Dermatology Princess Alexandra Hospital  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. Mark","family":"Smithers","sequence":"additional","affiliation":[{"name":"Queensland Melanoma Project Princess Alexandra Hospital, The University of Queensland  Brisbane Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Romina","family":"Spina","sequence":"additional","affiliation":[{"name":"Department of Surgery Veneto Institute of Oncology IOV\u2010IRCCS  Padua Italy"},{"name":"Psychology Unit University Hospital of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca G.","family":"Campana","sequence":"additional","affiliation":[{"name":"Department of Surgery The Christie NHS Foundation Trust  Manchester UK"},{"name":"Department of Surgical Oncological and Gastroenterological Sciences (DISCOG) University of Padova  Padova Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deemesh","family":"Oudit","sequence":"additional","affiliation":[{"name":"Department of Surgery The Christie NHS Foundation Trust  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