Surgery and adjuvant therapies in the treatment of stage IV melanoma: Our experience in 84 patients

Francesca Tauceri, Gianni Mura, Mauro Roseano, Massimo Framarini, Laura Ridolfi, Giorgio M. Verdecchia

Research output: Contribution to journalArticle

Abstract

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∈

Original languageEnglish
Pages (from-to)1079-1084
Number of pages6
JournalLangenbeck's Archives of Surgery
Volume394
Issue number6
DOIs
Publication statusPublished - Nov 2009

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Keywords

  • Adjuvant therapy
  • Metastatic melanoma
  • Surgical resection

ASJC Scopus subject areas

  • Surgery

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