Metastatic melanoma of the heart: Retrospective cohort study and systematic review of prevalence, clinical characteristics, and outcomes

Abstract Background Cardiac metastasis of melanoma is rare and typically diagnosed post‐mortem. Here we perform a retrospective cohort study and systematic review of patients with metastatic melanoma to characterize prevalence, clinical characteristics, and outcomes of cardiac metastasis. Methods We...

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Main Authors: Alexander M. Balinski, Alexi L. Vasbinder, Connor C. Kerndt, Tonimarie C. Catalan, Nathan P. Parry, Rafey A. Rehman, Pennelope Blakely, Raymond Y. Yeow, Monika J. Leja, Christopher D. Lao, Leslie A. Fecher, Salim S. Hayek
Format: Article
Language:English
Published: Wiley 2023-02-01
Series:Cancer Medicine
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Online Access:https://doi.org/10.1002/cam4.5058
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author Alexander M. Balinski
Alexi L. Vasbinder
Connor C. Kerndt
Tonimarie C. Catalan
Nathan P. Parry
Rafey A. Rehman
Pennelope Blakely
Raymond Y. Yeow
Monika J. Leja
Christopher D. Lao
Leslie A. Fecher
Salim S. Hayek
author_facet Alexander M. Balinski
Alexi L. Vasbinder
Connor C. Kerndt
Tonimarie C. Catalan
Nathan P. Parry
Rafey A. Rehman
Pennelope Blakely
Raymond Y. Yeow
Monika J. Leja
Christopher D. Lao
Leslie A. Fecher
Salim S. Hayek
author_sort Alexander M. Balinski
collection DOAJ
description Abstract Background Cardiac metastasis of melanoma is rare and typically diagnosed post‐mortem. Here we perform a retrospective cohort study and systematic review of patients with metastatic melanoma to characterize prevalence, clinical characteristics, and outcomes of cardiac metastasis. Methods We reviewed the electronic medical records of all outpatients with metastatic melanoma who underwent evaluation at the University of Michigan in Ann Arbor from January 2009 to January 2022, identifying patients with a clinical or histopathologic diagnosis of cardiac metastasis. We performed a systematic review of the literature to summarize the clinical characteristics and outcomes of patients with melanoma and cardiac metastasis. Results Overall, 23 of 1254 (1.8%) patients with metastatic melanoma were diagnosed with cardiac metastasis. Cardiac metastasis was reported in the right ventricle (65%), left ventricle (35%), and right atrium (35%). A total of 11 (48%) patients experienced at least one cardiovascular complication after the diagnosis of cardiac metastasis, the most common being arrhythmia (30%), heart failure (22%), and pericardial effusion (17%). Immunotherapy was more commonly used in patients with cardiac metastasis (80% vs 65%; p = 0.005). Mortality at 2‐years post‐diagnosis was higher for patients with cardiac metastasis compared to those without (59% vs 37%; p = 0.034). Progression of malignancy was the underlying cause of death of all patients. Conclusions Cardiac metastasis occurs in <2% of patients with metastatic melanoma, can affect all cardiac structures, and is associated with various cardiovascular complications and high mortality.
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spelling doaj-art-923ccc9b39a64ccc8c8887ffde6c41972024-11-25T07:56:31ZengWileyCancer Medicine2045-76342023-02-011232356236710.1002/cam4.5058Metastatic melanoma of the heart: Retrospective cohort study and systematic review of prevalence, clinical characteristics, and outcomesAlexander M. Balinski0Alexi L. Vasbinder1Connor C. Kerndt2Tonimarie C. Catalan3Nathan P. Parry4Rafey A. Rehman5Pennelope Blakely6Raymond Y. Yeow7Monika J. Leja8Christopher D. Lao9Leslie A. Fecher10Salim S. Hayek11Oakland University William Beaumont School of Medicine Rochester Michigan USADepartment of Internal Medicine, Division of Cardiology University of Michigan Ann Arbor Michigan USADepartment of Internal Medicine Spectrum Health/Michigan State University College of Human Medicine Grand Rapids Michigan USADepartment of Internal Medicine, Division of Cardiology University of Michigan Ann Arbor Michigan USAOakland University William Beaumont School of Medicine Rochester Michigan USAOakland University William Beaumont School of Medicine Rochester Michigan USADepartment of Internal Medicine, Division of Cardiology University of Michigan Ann Arbor Michigan USADepartment of Internal Medicine, Division of Cardiology University of Michigan Ann Arbor Michigan USADepartment of Internal Medicine, Division of Cardiology University of Michigan Ann Arbor Michigan USADepartment of Internal Medicine Division of Hematology/Oncology, University of Michigan Ann Arbor Michigan USADepartment of Internal Medicine Division of Hematology/Oncology, University of Michigan Ann Arbor Michigan USADepartment of Internal Medicine, Division of Cardiology University of Michigan Ann Arbor Michigan USAAbstract Background Cardiac metastasis of melanoma is rare and typically diagnosed post‐mortem. Here we perform a retrospective cohort study and systematic review of patients with metastatic melanoma to characterize prevalence, clinical characteristics, and outcomes of cardiac metastasis. Methods We reviewed the electronic medical records of all outpatients with metastatic melanoma who underwent evaluation at the University of Michigan in Ann Arbor from January 2009 to January 2022, identifying patients with a clinical or histopathologic diagnosis of cardiac metastasis. We performed a systematic review of the literature to summarize the clinical characteristics and outcomes of patients with melanoma and cardiac metastasis. Results Overall, 23 of 1254 (1.8%) patients with metastatic melanoma were diagnosed with cardiac metastasis. Cardiac metastasis was reported in the right ventricle (65%), left ventricle (35%), and right atrium (35%). A total of 11 (48%) patients experienced at least one cardiovascular complication after the diagnosis of cardiac metastasis, the most common being arrhythmia (30%), heart failure (22%), and pericardial effusion (17%). Immunotherapy was more commonly used in patients with cardiac metastasis (80% vs 65%; p = 0.005). Mortality at 2‐years post‐diagnosis was higher for patients with cardiac metastasis compared to those without (59% vs 37%; p = 0.034). Progression of malignancy was the underlying cause of death of all patients. Conclusions Cardiac metastasis occurs in <2% of patients with metastatic melanoma, can affect all cardiac structures, and is associated with various cardiovascular complications and high mortality.https://doi.org/10.1002/cam4.5058epidemiologymelanomametastasisprognosis
spellingShingle Alexander M. Balinski
Alexi L. Vasbinder
Connor C. Kerndt
Tonimarie C. Catalan
Nathan P. Parry
Rafey A. Rehman
Pennelope Blakely
Raymond Y. Yeow
Monika J. Leja
Christopher D. Lao
Leslie A. Fecher
Salim S. Hayek
Metastatic melanoma of the heart: Retrospective cohort study and systematic review of prevalence, clinical characteristics, and outcomes
Cancer Medicine
epidemiology
melanoma
metastasis
prognosis
title Metastatic melanoma of the heart: Retrospective cohort study and systematic review of prevalence, clinical characteristics, and outcomes
title_full Metastatic melanoma of the heart: Retrospective cohort study and systematic review of prevalence, clinical characteristics, and outcomes
title_fullStr Metastatic melanoma of the heart: Retrospective cohort study and systematic review of prevalence, clinical characteristics, and outcomes
title_full_unstemmed Metastatic melanoma of the heart: Retrospective cohort study and systematic review of prevalence, clinical characteristics, and outcomes
title_short Metastatic melanoma of the heart: Retrospective cohort study and systematic review of prevalence, clinical characteristics, and outcomes
title_sort metastatic melanoma of the heart retrospective cohort study and systematic review of prevalence clinical characteristics and outcomes
topic epidemiology
melanoma
metastasis
prognosis
url https://doi.org/10.1002/cam4.5058
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