{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:25:34Z","timestamp":1791851134849,"version":"4.3.4"},"reference-count":38,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,6,24]],"date-time":"2024-06-24T00:00:00Z","timestamp":1719187200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2024,10,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Previous studies demonstrated limited efficacy of immune checkpoint inhibitors in unresectable acral melanoma (AM); it remains unclear how this translates to the adjuvant setting. This study investigates clinical outcomes of acral compared to cutaneous melanoma (CM) patients treated with adjuvant anti\u2010PD\u20101 after complete resection. All stages III\u2013IV AM and CM patients receiving adjuvant anti\u2010PD\u20101 after complete resection between 2018 and 2022 were included from the prospective nationwide Dutch Melanoma Treatment Registry. We analyzed recurrence\u2010free survival (RFS), distant metastasis\u2010free survival (DMFS), and overall survival (OS). A multivariable Cox regression analysis of RFS was performed to adjust for potential confounders. We included 1958 (86\u2009AM and 1872 CM) patients. At baseline, AM patients more frequently had\n                    <jats:italic>KIT<\/jats:italic>\n                    mutations, higher disease stages, and Eastern Cooperative Oncology Group Performance Status, and fewer\n                    <jats:italic>BRAF<\/jats:italic>\n                    and\n                    <jats:italic>NRAS<\/jats:italic>\n                    mutations. Median RFS was 14.8\u2009months (95% confidence interval [CI]: 11.5\u201329.3) in AM and 37.4\u2009months (95% CI: 34.6 to not reached) in CM (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.002). After correcting for potential confounders, AM remained associated with a higher risk of recurrence (HR\n                    <jats:sub>adj<\/jats:sub>\n                    1.53; 95% CI: 1.07\u20132.17;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.019). Two\u2010year DMFS tended to be worse for AM than for CM: 64.5% versus 79.7% (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.050). Two\u2010year OS was significantly lower in AM (71.5% vs. 84.3%;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u2009.027). The results of this study suggest a poorer outcome of adjuvant\u2010treated AM compared to CM. Studies assessing the added value of adjuvant treatment in AM are needed. Future research should investigate alternative treatment strategies to improve outcomes of high\u2010risk AM.\n                  <\/jats:p>","DOI":"10.1002\/ijc.35060","type":"journal-article","created":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:28:42Z","timestamp":1719275322000},"page":"1455-1465","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Adjuvant treatment with anti\u2010\n                    <scp>PD<\/scp>\n                    \u20101 in acral melanoma: A nationwide study"],"prefix":"10.1002","volume":"155","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9843-4285","authenticated-orcid":false,"given":"Manja","family":"Bloem","sequence":"first","affiliation":[{"name":"Scientific Bureau, Dutch Institute for Clinical Auditing  Leiden The Netherlands"},{"name":"Department of Biomedical Data Sciences Leiden University Medical Centre  Leiden The Netherlands"},{"name":"Department of Surgical Oncology Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3099-4873","authenticated-orcid":false,"given":"Olivier J.","family":"van Not","sequence":"additional","affiliation":[{"name":"Scientific Bureau, Dutch Institute for Clinical Auditing  Leiden The Netherlands"},{"name":"Department of Medical Oncology, University Medical Center Utrecht Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen J. B.","family":"Aarts","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, GROW School for Oncology and Developmental Biology Maastricht University Medical Centre  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franchette W. P. J.","family":"van den Berkmortel","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Zuyderland Medical Centre Sittard  Sittard\u2010Geleen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian U.","family":"Blank","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Immunology Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willeke A. M.","family":"Blokx","sequence":"additional","affiliation":[{"name":"Department of Pathology University Medical Center Utrecht  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marye J.","family":"Boers\u2010Sonderen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Radboud University Medical Centre  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes J.","family":"Bonenkamp","sequence":"additional","affiliation":[{"name":"Department of Surgery Radboud University Medical Centre  Nijmegen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan\u2010Willem B.","family":"de Groot","sequence":"additional","affiliation":[{"name":"Isala Oncology Center  Zwolle The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John B.","family":"Haanen","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology and Immunology Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geke A. P.","family":"Hospers","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, University Medical Centre Groningen University of Groningen  Groningen The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen W.","family":"Kapiteijn","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Leiden University Medical Centre  Leiden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1306-2713","authenticated-orcid":false,"given":"Melissa M.","family":"de Meza","sequence":"additional","affiliation":[{"name":"Scientific Bureau, Dutch Institute for Clinical Auditing  Leiden The Netherlands"},{"name":"Department of Biomedical Data Sciences Leiden University Medical Centre  Leiden The Netherlands"},{"name":"Department of Surgical Oncology Netherlands Cancer Institute  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Djura","family":"Piersma","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Medisch Spectrum Twente  Enschede The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rozemarijn S.","family":"van Rijn","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Medical Centre Leeuwarden  Leeuwarden The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion A. M.","family":"Stevense\u2010den Boer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Amphia Hospital  Breda The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astrid A. M.","family":"van der Veldt","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology Erasmus Medical Centre  Rotterdam The Netherlands"},{"name":"Department of Radiology and Nuclear Medicine Erasmus Medical Centre  Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerard","family":"Vreugdenhil","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Maxima Medical Centre  Eindhoven The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfons J. 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