BACKGROUND AND AIMS: Survival rates of patients with stage IV melanoma are poor: Median survival is 7-8 months and 5-year survival rates about 5%. There is no agreement on the role of surgery at this stage. Most patients with metastatic melanoma are not able to undergo resection and usually are sent to systemic chemo- and immunotherapy. PATIENTS AND METHODS: Eighty-four patients operated on for stage IV melanoma were evaluated. Of them, 61.9% were submitted to reiterative surgery with 168 operations and 182 surgical procedures overall. A total of 90.5% was submitted to adjuvant therapies according to aggressive and reiterated schedules: chemotherapy, immunotherapy, dendritic cells vaccine, infusion of tumor infiltrating lymphocytes, local therapies as electrochemotherapy. RESULTS: The mean overall survival (Kaplan-Meier) was 56.7 months (1 year: 72.1%, 3 years: 46.5%, 5 years: 23.16%). The survival of reiterative surgery was significatively longer than single surgery (62.7 vs 42.4 months, median 50.9 vs 16.0), p = 0.03. Multivariated Cox analysis was performed for disease-free interval, repeated surgery, adjuvant therapies, and site of metastasis according to the American Joint Committee on Cancer: Reiterative surgery was shown as an independent prognostic factor (p < 0.05). CONCLUSION: Metastatic resection associated with adjuvant therapy may improve overall survival and, in some instances, can provide long-term survival, whatever site and numbers of metastasis. In our series, reiterative surgery was more significatively efficient in improving survival than single-time surgery.
BACKGROUND AND AIMS: Survival rates of patients with stage IV melanoma are poor: Median survival is 7-8 months and 5-year survival rates about 5%. There is no agreement on the role of surgery at this stage. Most patients with metastatic melanoma are not able to undergo resection and usually are sent to systemic chemo- and immunotherapy. PATIENTS AND METHODS: Eighty-four patients operated on for stage IV melanoma were evaluated. Of them, 61.9% were submitted to reiterative surgery with 168 operations and 182 surgical procedures overall. A total of 90.5% was submitted to adjuvant therapies according to aggressive and reiterated schedules: chemotherapy, immunotherapy, dendritic cells vaccine, infusion of tumor infiltrating lymphocytes, local therapies as electrochemotherapy. RESULTS: The mean overall survival (Kaplan-Meier) was 56.7 months (1 year: 72.1%, 3 years: 46.5%, 5 years: 23.16%). The survival of reiterative surgery was significatively longer than single surgery (62.7 vs 42.4 months, median 50.9 vs 16.0), p = 0.03. Multivariated Cox analysis was performed for disease-free interval, repeated surgery, adjuvant therapies, and site of metastasis according to the American Joint Committee on Cancer: Reiterative surgery was shown as an independent prognostic factor (p < 0.05). CONCLUSION: Metastatic resection associated with adjuvant therapy may improve overall survival and, in some instances, can provide long-term survival, whatever site and numbers of metastasis. In our series, reiterative surgery was more significatively efficient in improving survival than single-time surgery.
Authors: Shawn E Young; Steve R Martinez; Mark B Faries; Richard Essner; Leslie A Wanek; Donald L Morton Journal: Cancer J Date: 2006 May-Jun Impact factor: 3.360
Authors: T F Wood; L A DiFronzo; D M Rose; P I Haigh; S L Stern; L Wanek; R Essner; D L Morton Journal: Ann Surg Oncol Date: 2001-09 Impact factor: 5.344
Authors: L G Feun; J Gutterman; M A Burgess; E M Hersh; G Mavligit; C M McBride; R S Benjamin; S P Richman; W K Murphy; G P Bodey; B W Brown; C F Mountain; M E Leavens; E J Freireich Journal: Cancer Date: 1982-10-15 Impact factor: 6.860
Authors: G M Verdecchia; L Ridolfi; R Ridolfi; A Riccobon; A Bertagni; A Vagliasindi; M Petrini; M Stefanelli; C Milandri; D Amadori Journal: Tumori Date: 2003 Jul-Aug Impact factor: 2.098
Authors: Marta Batus; Salman Waheed; Carl Ruby; Lindsay Petersen; Steven D Bines; Howard L Kaufman Journal: Am J Clin Dermatol Date: 2013-06 Impact factor: 7.403
Authors: Corrado Caracò; Ugo Marone; Ester Simeone; Antonio Maria Grimaldi; Gerardo Botti; Maurizio Del Giudice; Paolo Antonio Ascierto; Nicola Mozzillo Journal: Melanoma Manag Date: 2015-05-18