BACKGROUND: On the basis of retrospective experience at individual centers, it appears that patients with stage IV melanoma who undergo complete resection have a favorable outcome compared with patients with disseminated stage IV disease. The Southwest Oncology Group (SWOG) performed a prospective trial in patients with metastatic melanoma who were enrolled before complete resection of their metastatic disease and provided prospective outcomes in the cooperative group setting. METHODS: Based on their physical examination and radiologic imaging studies, patients with a stage IV melanoma judged amenable to complete resection underwent surgery within 28 days of enrollment. All eligible patients were followed with scans (computed tomography or positron emission tomography) every 6 months until relapse and death. RESULTS: Seventy-seven patients were enrolled from 18 different centers. Of those, 5 patients were ineligible; 2 had stage III disease alone; and 3 had no melanoma in their surgical specimen. In addition, 8 eligible patients had incompletely resected tumor. Therefore, the primary analysis included 64 completely resected patients. Twenty patients (31%) had visceral disease. With a median follow-up of 5 years, the median relapse-free survival was 5 months (95% CI, 3-7 months) whereas median overall survival was 21 months (95% CI, 16-34 months). Overall survivals at 3 and 4 years were 36% and 31%, respectively. CONCLUSIONS: In a prospective multicenter setting, appropriately selected patients with stage IV melanoma achieved prolonged overall survival after complete surgical resection. Although median relapse-free survival was only 5 months, patients could still frequently undergo subsequent surgery for isolated recurrences. This patient population is appropriate for aggressive surgical therapy and for trials evaluating adjuvant therapy.
BACKGROUND: On the basis of retrospective experience at individual centers, it appears that patients with stage IV melanoma who undergo complete resection have a favorable outcome compared with patients with disseminated stage IV disease. The Southwest Oncology Group (SWOG) performed a prospective trial in patients with metastatic melanoma who were enrolled before complete resection of their metastatic disease and provided prospective outcomes in the cooperative group setting. METHODS: Based on their physical examination and radiologic imaging studies, patients with a stage IV melanoma judged amenable to complete resection underwent surgery within 28 days of enrollment. All eligible patients were followed with scans (computed tomography or positron emission tomography) every 6 months until relapse and death. RESULTS: Seventy-seven patients were enrolled from 18 different centers. Of those, 5 patients were ineligible; 2 had stage III disease alone; and 3 had no melanoma in their surgical specimen. In addition, 8 eligible patients had incompletely resected tumor. Therefore, the primary analysis included 64 completely resected patients. Twenty patients (31%) had visceral disease. With a median follow-up of 5 years, the median relapse-free survival was 5 months (95% CI, 3-7 months) whereas median overall survival was 21 months (95% CI, 16-34 months). Overall survivals at 3 and 4 years were 36% and 31%, respectively. CONCLUSIONS: In a prospective multicenter setting, appropriately selected patients with stage IV melanoma achieved prolonged overall survival after complete surgical resection. Although median relapse-free survival was only 5 months, patients could still frequently undergo subsequent surgery for isolated recurrences. This patient population is appropriate for aggressive surgical therapy and for trials evaluating adjuvant therapy.
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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: M B Atkins; M T Lotze; J P Dutcher; R I Fisher; G Weiss; K Margolin; J Abrams; M Sznol; D Parkinson; M Hawkins; C Paradise; L Kunkel; S A Rosenberg Journal: J Clin Oncol Date: 1999-07 Impact factor: 44.544
Authors: P B Chapman; L H Einhorn; M L Meyers; S Saxman; A N Destro; K S Panageas; C B Begg; S S Agarwala; L M Schuchter; M S Ernstoff; A N Houghton; J M Kirkwood Journal: J Clin Oncol Date: 1999-09 Impact factor: 44.544
Authors: Eddy C Hsueh; Richard Essner; Leland J Foshag; David W Ollila; Guy Gammon; Steven J O'Day; Peter D Boasberg; Stacey L Stern; Xing Ye; Donald L Morton Journal: J Clin Oncol Date: 2002-12-01 Impact factor: 44.544
Authors: Charles M Balch; Jeffrey E Gershenwald; Seng-Jaw Soong; John F Thompson; Michael B Atkins; David R Byrd; Antonio C Buzaid; Alistair J Cochran; Daniel G Coit; Shouluan Ding; Alexander M Eggermont; Keith T Flaherty; Phyllis A Gimotty; John M Kirkwood; Kelly M McMasters; Martin C Mihm; Donald L Morton; Merrick I Ross; Arthur J Sober; Vernon K Sondak Journal: J Clin Oncol Date: 2009-11-16 Impact factor: 44.544
Authors: J Harrison Howard; John F Thompson; Nicola Mozzillo; Omgo E Nieweg; Harald J Hoekstra; Daniel F Roses; Vernon K Sondak; Douglas S Reintgen; Mohammed Kashani-Sabet; Constantine P Karakousis; Brendon J Coventry; William G Kraybill; B Mark Smithers; Robert Elashoff; Stacey L Stern; Alistair J Cochran; Mark B Faries; Donald L Morton Journal: Ann Surg Oncol Date: 2012-05-31 Impact factor: 5.344
Authors: Danielle M Bello; Katherine S Panageas; Travis Hollmann; Alexander N Shoushtari; Parisa Momtaz; Paul B Chapman; Michael A Postow; Margaret K Callahan; Jedd D Wolchok; Mary S Brady; Daniel G Coit; Charlotte E Ariyan Journal: Ann Surg Oncol Date: 2019-12-17 Impact factor: 5.344
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