INTRODUCTION: Patients with Stage IV melanoma have limited therapeutic options with few long-term survivors. Our goal was to study the impact of metastasectomy on survival in these patients. METHODS: Patients with Stage IV melanoma were identified from the Surveillance, Epidemiology, and End Results (SEER) database (1988-2006). Those who had metastasectomy performed were compared with patients that did not. RESULTS: The median age of the study population (n = 4,229) was 63 years and median survival was 7 months. Patients who underwent metastasectomy (33.6%) had an improved median and 5-year overall survival as compared to patients who did not; 12 months versus 5 months and 16% versus 7% (P < 0.001). In patients with M1a disease (n = 1,994), this improvement of survival following metastasectomy was enhanced; median survival of 14 months versus 6 months and 5-year overall survival of 20% versus 9% (P < 0.001). Younger age and diagnosis from 2001 to 2006 were predictors of metastasectomy. Metastasectomy was an independent and significant predictor of survival for the entire cohort (HR 0.59, 95% CI 0.55-0.63). CONCLUSIONS: Metastasectomy in patients with Stage IV melanoma may improve long-term survival. The true therapeutic benefit, if any, of metastatectomy needs to be determined by a randomized trial.
INTRODUCTION:Patients with Stage IV melanoma have limited therapeutic options with few long-term survivors. Our goal was to study the impact of metastasectomy on survival in these patients. METHODS:Patients with Stage IV melanoma were identified from the Surveillance, Epidemiology, and End Results (SEER) database (1988-2006). Those who had metastasectomy performed were compared with patients that did not. RESULTS: The median age of the study population (n = 4,229) was 63 years and median survival was 7 months. Patients who underwent metastasectomy (33.6%) had an improved median and 5-year overall survival as compared to patients who did not; 12 months versus 5 months and 16% versus 7% (P < 0.001). In patients with M1a disease (n = 1,994), this improvement of survival following metastasectomy was enhanced; median survival of 14 months versus 6 months and 5-year overall survival of 20% versus 9% (P < 0.001). Younger age and diagnosis from 2001 to 2006 were predictors of metastasectomy. Metastasectomy was an independent and significant predictor of survival for the entire cohort (HR 0.59, 95% CI 0.55-0.63). CONCLUSIONS: Metastasectomy in patients with Stage IV melanoma may improve long-term survival. The true therapeutic benefit, if any, of metastatectomy needs to be determined by a randomized trial.
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: C M Balch; S J Soong; J E Gershenwald; J F Thompson; D S Reintgen; N Cascinelli; M Urist; K M McMasters; M I Ross; J M Kirkwood; M B Atkins; J A Thompson; D G Coit; D Byrd; R Desmond; Y Zhang; P Y Liu; G H Lyman; A Morabito Journal: J Clin Oncol Date: 2001-08-15 Impact factor: 44.544
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