Metastasectomy for Distant Metastatic Melanoma: Analysis of Data from the First Multicenter Selective Lymphadenectomy Trial (MSLT-I)
Background For stage IV melanoma, systemic medical therapy (SMT) is used most frequently; surgery is considered an adjunct in selected patients. We retrospectively compared survival after surgery with or without SMT versus SMT alone for melanoma patients developing distant metastases while enrolled...
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| Veröffentlicht in: | Annals of surgical oncology 2012-08, Vol.19 (8), p.2547-2555 |
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| creator | Howard, J. Harrison Thompson, John F. Mozzillo, Nicola Nieweg, Omgo E. Hoekstra, Harald J. Roses, Daniel F. Sondak, Vernon K. Reintgen, Douglas S. Kashani-Sabet, Mohammed Karakousis, Constantine P. Coventry, Brendon J. Kraybill, William G. Smithers, B. Mark Elashoff, Robert Stern, Stacey L. Cochran, Alistair J. Faries, Mark B. Morton, Donald L. |
| description | Background
For stage IV melanoma, systemic medical therapy (SMT) is used most frequently; surgery is considered an adjunct in selected patients. We retrospectively compared survival after surgery with or without SMT versus SMT alone for melanoma patients developing distant metastases while enrolled in the first Multicenter Selective Lymphadenectomy Trial.
Methods
Patients were randomized to wide excision and sentinel node biopsy, or wide excision and nodal observation. We evaluated recurrence site, therapy (selected by treating clinician), and survival after stage IV diagnosis.
Results
Of 291 patients with complete data for stage IV recurrence, 161 (55 %) underwent surgery with or without SMT. Median survival was 15.8 versus 6.9 months, and 4-year survival was 20.8 versus 7.0 % for patients receiving surgery with or without SMT versus SMT alone (
p
60 months vs. 12.4 months; 4-year survival 69.3 % vs. 0;
p
= 0.0106), M1b (median 17.9 vs. 9.1 months; 4-year survival 24.1 vs. 14.3 %;
p
= 0.1143), and M1c (median 15.0 vs. 6.3 months; 4-year survival 10.5 vs. 4.6 %;
p
= 0.0001) disease. Patients with multiple metastases treated surgically had a survival advantage, and number of operations did not reduce survival in the 67 patients (42 %) who had multiple surgeries for distant melanoma.
Conclusions
Our findings suggest that over half of stage IV patients are candidates for resection and exhibit improved survival over patients receiving SMT alone, regardless of site and number of metastases. We have begun a multicenter randomized phase III trial comparing surgery versus SMT as initial treatment for resectable distant melanoma. |
| doi_str_mv | 10.1245/s10434-012-2398-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3405182</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2719660491</sourcerecordid><originalsourceid>FETCH-LOGICAL-c536t-c26fa846ab6babb92c69ce32722852a9aea60bb42e39e278fad9fb9cf5cf04ce3</originalsourceid><addsrcrecordid>eNp1kd9rFDEQxxdRbK3-Ab5IwJf6sJpkk1zig1D6QwtXfOj5HGZzk17K7uZMdgvXZ__w5ryzVEEIJMx85juT-VbVW0Y_Mi7kp8yoaERNGa95Y3R9_6w6ZLJEhNLseXlTpWvDlTyoXuV8SymbNVS-rA44V0JLKQ6rX1c4Qi4H3Rj7DfExkbNQAsNI9qkxuPLsYIg9fCYnA3SbHDKJnpzBCMSn2JNxheQipFyKpq4U4DBiItfYFdlwh2S-6dcrWOKwb7NIATpyfHU9X9SXH15XLzx0Gd_s76Pqx8X54vRbPf_-9fL0ZF472aixdlx50EJBq1poW8OdMg4bPuNcSw4GEBRtW8GxMchn2sPS-NY4L52nopBH1Zed7npqe1xup0zQ2XUKPaSNjRDs35khrOxNvLONoJJpXgSO9wIp_pwwj7YP2WFXloNxypZRrinTYmYK-v4f9DZOqSzvN1UAzk1TKLajXIo5J_SPwzBqtx7bnce2eGy3Htv7UvPu6S8eK_6YWgC-A3JJDTeYnrb-n-oD6Si1eg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1027932293</pqid></control><display><type>article</type><title>Metastasectomy for Distant Metastatic Melanoma: Analysis of Data from the First Multicenter Selective Lymphadenectomy Trial (MSLT-I)</title><source>MEDLINE</source><source>SpringerLink Journals - AutoHoldings</source><creator>Howard, J. Harrison ; Thompson, John F. ; Mozzillo, Nicola ; Nieweg, Omgo E. ; Hoekstra, Harald J. ; Roses, Daniel F. ; Sondak, Vernon K. ; Reintgen, Douglas S. ; Kashani-Sabet, Mohammed ; Karakousis, Constantine P. ; Coventry, Brendon J. ; Kraybill, William G. ; Smithers, B. Mark ; Elashoff, Robert ; Stern, Stacey L. ; Cochran, Alistair J. ; Faries, Mark B. ; Morton, Donald L.</creator><creatorcontrib>Howard, J. Harrison ; Thompson, John F. ; Mozzillo, Nicola ; Nieweg, Omgo E. ; Hoekstra, Harald J. ; Roses, Daniel F. ; Sondak, Vernon K. ; Reintgen, Douglas S. ; Kashani-Sabet, Mohammed ; Karakousis, Constantine P. ; Coventry, Brendon J. ; Kraybill, William G. ; Smithers, B. Mark ; Elashoff, Robert ; Stern, Stacey L. ; Cochran, Alistair J. ; Faries, Mark B. ; Morton, Donald L.</creatorcontrib><description>Background
For stage IV melanoma, systemic medical therapy (SMT) is used most frequently; surgery is considered an adjunct in selected patients. We retrospectively compared survival after surgery with or without SMT versus SMT alone for melanoma patients developing distant metastases while enrolled in the first Multicenter Selective Lymphadenectomy Trial.
Methods
Patients were randomized to wide excision and sentinel node biopsy, or wide excision and nodal observation. We evaluated recurrence site, therapy (selected by treating clinician), and survival after stage IV diagnosis.
Results
Of 291 patients with complete data for stage IV recurrence, 161 (55 %) underwent surgery with or without SMT. Median survival was 15.8 versus 6.9 months, and 4-year survival was 20.8 versus 7.0 % for patients receiving surgery with or without SMT versus SMT alone (
p
< 0.0001; hazard ratio 0.406). Surgery with or without SMT conferred a survival advantage for patients with M1a (median > 60 months vs. 12.4 months; 4-year survival 69.3 % vs. 0;
p
= 0.0106), M1b (median 17.9 vs. 9.1 months; 4-year survival 24.1 vs. 14.3 %;
p
= 0.1143), and M1c (median 15.0 vs. 6.3 months; 4-year survival 10.5 vs. 4.6 %;
p
= 0.0001) disease. Patients with multiple metastases treated surgically had a survival advantage, and number of operations did not reduce survival in the 67 patients (42 %) who had multiple surgeries for distant melanoma.
Conclusions
Our findings suggest that over half of stage IV patients are candidates for resection and exhibit improved survival over patients receiving SMT alone, regardless of site and number of metastases. We have begun a multicenter randomized phase III trial comparing surgery versus SMT as initial treatment for resectable distant melanoma.</description><identifier>ISSN: 1068-9265</identifier><identifier>EISSN: 1534-4681</identifier><identifier>DOI: 10.1245/s10434-012-2398-z</identifier><identifier>PMID: 22648554</identifier><language>eng</language><publisher>New York: Springer-Verlag</publisher><subject>Female ; Follow-Up Studies ; Humans ; Lymph Node Excision - mortality ; Lymphatic Metastasis ; Male ; Medicine ; Medicine & Public Health ; Melanoma ; Melanoma - mortality ; Melanoma - secondary ; Melanoma - surgery ; Metastasectomy - mortality ; Middle Aged ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - pathology ; Neoplasm Recurrence, Local - surgery ; Neoplasm Staging ; Oncology ; Prognosis ; Retrospective Studies ; Skin Neoplasms - mortality ; Skin Neoplasms - pathology ; Skin Neoplasms - surgery ; Surgery ; Surgical Oncology ; Survival Rate</subject><ispartof>Annals of surgical oncology, 2012-08, Vol.19 (8), p.2547-2555</ispartof><rights>Society of Surgical Oncology 2012</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c536t-c26fa846ab6babb92c69ce32722852a9aea60bb42e39e278fad9fb9cf5cf04ce3</citedby><cites>FETCH-LOGICAL-c536t-c26fa846ab6babb92c69ce32722852a9aea60bb42e39e278fad9fb9cf5cf04ce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1245/s10434-012-2398-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1245/s10434-012-2398-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22648554$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Howard, J. Harrison</creatorcontrib><creatorcontrib>Thompson, John F.</creatorcontrib><creatorcontrib>Mozzillo, Nicola</creatorcontrib><creatorcontrib>Nieweg, Omgo E.</creatorcontrib><creatorcontrib>Hoekstra, Harald J.</creatorcontrib><creatorcontrib>Roses, Daniel F.</creatorcontrib><creatorcontrib>Sondak, Vernon K.</creatorcontrib><creatorcontrib>Reintgen, Douglas S.</creatorcontrib><creatorcontrib>Kashani-Sabet, Mohammed</creatorcontrib><creatorcontrib>Karakousis, Constantine P.</creatorcontrib><creatorcontrib>Coventry, Brendon J.</creatorcontrib><creatorcontrib>Kraybill, William G.</creatorcontrib><creatorcontrib>Smithers, B. Mark</creatorcontrib><creatorcontrib>Elashoff, Robert</creatorcontrib><creatorcontrib>Stern, Stacey L.</creatorcontrib><creatorcontrib>Cochran, Alistair J.</creatorcontrib><creatorcontrib>Faries, Mark B.</creatorcontrib><creatorcontrib>Morton, Donald L.</creatorcontrib><title>Metastasectomy for Distant Metastatic Melanoma: Analysis of Data from the First Multicenter Selective Lymphadenectomy Trial (MSLT-I)</title><title>Annals of surgical oncology</title><addtitle>Ann Surg Oncol</addtitle><addtitle>Ann Surg Oncol</addtitle><description>Background
For stage IV melanoma, systemic medical therapy (SMT) is used most frequently; surgery is considered an adjunct in selected patients. We retrospectively compared survival after surgery with or without SMT versus SMT alone for melanoma patients developing distant metastases while enrolled in the first Multicenter Selective Lymphadenectomy Trial.
Methods
Patients were randomized to wide excision and sentinel node biopsy, or wide excision and nodal observation. We evaluated recurrence site, therapy (selected by treating clinician), and survival after stage IV diagnosis.
Results
Of 291 patients with complete data for stage IV recurrence, 161 (55 %) underwent surgery with or without SMT. Median survival was 15.8 versus 6.9 months, and 4-year survival was 20.8 versus 7.0 % for patients receiving surgery with or without SMT versus SMT alone (
p
< 0.0001; hazard ratio 0.406). Surgery with or without SMT conferred a survival advantage for patients with M1a (median > 60 months vs. 12.4 months; 4-year survival 69.3 % vs. 0;
p
= 0.0106), M1b (median 17.9 vs. 9.1 months; 4-year survival 24.1 vs. 14.3 %;
p
= 0.1143), and M1c (median 15.0 vs. 6.3 months; 4-year survival 10.5 vs. 4.6 %;
p
= 0.0001) disease. Patients with multiple metastases treated surgically had a survival advantage, and number of operations did not reduce survival in the 67 patients (42 %) who had multiple surgeries for distant melanoma.
Conclusions
Our findings suggest that over half of stage IV patients are candidates for resection and exhibit improved survival over patients receiving SMT alone, regardless of site and number of metastases. We have begun a multicenter randomized phase III trial comparing surgery versus SMT as initial treatment for resectable distant melanoma.</description><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lymph Node Excision - mortality</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Melanoma</subject><subject>Melanoma - mortality</subject><subject>Melanoma - secondary</subject><subject>Melanoma - surgery</subject><subject>Metastasectomy - mortality</subject><subject>Middle Aged</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Skin Neoplasms - mortality</subject><subject>Skin Neoplasms - pathology</subject><subject>Skin Neoplasms - surgery</subject><subject>Surgery</subject><subject>Surgical Oncology</subject><subject>Survival Rate</subject><issn>1068-9265</issn><issn>1534-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kd9rFDEQxxdRbK3-Ab5IwJf6sJpkk1zig1D6QwtXfOj5HGZzk17K7uZMdgvXZ__w5ryzVEEIJMx85juT-VbVW0Y_Mi7kp8yoaERNGa95Y3R9_6w6ZLJEhNLseXlTpWvDlTyoXuV8SymbNVS-rA44V0JLKQ6rX1c4Qi4H3Rj7DfExkbNQAsNI9qkxuPLsYIg9fCYnA3SbHDKJnpzBCMSn2JNxheQipFyKpq4U4DBiItfYFdlwh2S-6dcrWOKwb7NIATpyfHU9X9SXH15XLzx0Gd_s76Pqx8X54vRbPf_-9fL0ZF472aixdlx50EJBq1poW8OdMg4bPuNcSw4GEBRtW8GxMchn2sPS-NY4L52nopBH1Zed7npqe1xup0zQ2XUKPaSNjRDs35khrOxNvLONoJJpXgSO9wIp_pwwj7YP2WFXloNxypZRrinTYmYK-v4f9DZOqSzvN1UAzk1TKLajXIo5J_SPwzBqtx7bnce2eGy3Htv7UvPu6S8eK_6YWgC-A3JJDTeYnrb-n-oD6Si1eg</recordid><startdate>20120801</startdate><enddate>20120801</enddate><creator>Howard, J. Harrison</creator><creator>Thompson, John F.</creator><creator>Mozzillo, Nicola</creator><creator>Nieweg, Omgo E.</creator><creator>Hoekstra, Harald J.</creator><creator>Roses, Daniel F.</creator><creator>Sondak, Vernon K.</creator><creator>Reintgen, Douglas S.</creator><creator>Kashani-Sabet, Mohammed</creator><creator>Karakousis, Constantine P.</creator><creator>Coventry, Brendon J.</creator><creator>Kraybill, William G.</creator><creator>Smithers, B. Mark</creator><creator>Elashoff, Robert</creator><creator>Stern, Stacey L.</creator><creator>Cochran, Alistair J.</creator><creator>Faries, Mark B.</creator><creator>Morton, Donald L.</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7TO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20120801</creationdate><title>Metastasectomy for Distant Metastatic Melanoma: Analysis of Data from the First Multicenter Selective Lymphadenectomy Trial (MSLT-I)</title><author>Howard, J. Harrison ; Thompson, John F. ; Mozzillo, Nicola ; Nieweg, Omgo E. ; Hoekstra, Harald J. ; Roses, Daniel F. ; Sondak, Vernon K. ; Reintgen, Douglas S. ; Kashani-Sabet, Mohammed ; Karakousis, Constantine P. ; Coventry, Brendon J. ; Kraybill, William G. ; Smithers, B. Mark ; Elashoff, Robert ; Stern, Stacey L. ; Cochran, Alistair J. ; Faries, Mark B. ; Morton, Donald L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c536t-c26fa846ab6babb92c69ce32722852a9aea60bb42e39e278fad9fb9cf5cf04ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Lymph Node Excision - mortality</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Melanoma</topic><topic>Melanoma - mortality</topic><topic>Melanoma - secondary</topic><topic>Melanoma - surgery</topic><topic>Metastasectomy - mortality</topic><topic>Middle Aged</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>Neoplasm Staging</topic><topic>Oncology</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Skin Neoplasms - mortality</topic><topic>Skin Neoplasms - pathology</topic><topic>Skin Neoplasms - surgery</topic><topic>Surgery</topic><topic>Surgical Oncology</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Howard, J. Harrison</creatorcontrib><creatorcontrib>Thompson, John F.</creatorcontrib><creatorcontrib>Mozzillo, Nicola</creatorcontrib><creatorcontrib>Nieweg, Omgo E.</creatorcontrib><creatorcontrib>Hoekstra, Harald J.</creatorcontrib><creatorcontrib>Roses, Daniel F.</creatorcontrib><creatorcontrib>Sondak, Vernon K.</creatorcontrib><creatorcontrib>Reintgen, Douglas S.</creatorcontrib><creatorcontrib>Kashani-Sabet, Mohammed</creatorcontrib><creatorcontrib>Karakousis, Constantine P.</creatorcontrib><creatorcontrib>Coventry, Brendon J.</creatorcontrib><creatorcontrib>Kraybill, William G.</creatorcontrib><creatorcontrib>Smithers, B. Mark</creatorcontrib><creatorcontrib>Elashoff, Robert</creatorcontrib><creatorcontrib>Stern, Stacey L.</creatorcontrib><creatorcontrib>Cochran, Alistair J.</creatorcontrib><creatorcontrib>Faries, Mark B.</creatorcontrib><creatorcontrib>Morton, Donald L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Annals of surgical oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Howard, J. Harrison</au><au>Thompson, John F.</au><au>Mozzillo, Nicola</au><au>Nieweg, Omgo E.</au><au>Hoekstra, Harald J.</au><au>Roses, Daniel F.</au><au>Sondak, Vernon K.</au><au>Reintgen, Douglas S.</au><au>Kashani-Sabet, Mohammed</au><au>Karakousis, Constantine P.</au><au>Coventry, Brendon J.</au><au>Kraybill, William G.</au><au>Smithers, B. Mark</au><au>Elashoff, Robert</au><au>Stern, Stacey L.</au><au>Cochran, Alistair J.</au><au>Faries, Mark B.</au><au>Morton, Donald L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Metastasectomy for Distant Metastatic Melanoma: Analysis of Data from the First Multicenter Selective Lymphadenectomy Trial (MSLT-I)</atitle><jtitle>Annals of surgical oncology</jtitle><stitle>Ann Surg Oncol</stitle><addtitle>Ann Surg Oncol</addtitle><date>2012-08-01</date><risdate>2012</risdate><volume>19</volume><issue>8</issue><spage>2547</spage><epage>2555</epage><pages>2547-2555</pages><issn>1068-9265</issn><eissn>1534-4681</eissn><abstract>Background
For stage IV melanoma, systemic medical therapy (SMT) is used most frequently; surgery is considered an adjunct in selected patients. We retrospectively compared survival after surgery with or without SMT versus SMT alone for melanoma patients developing distant metastases while enrolled in the first Multicenter Selective Lymphadenectomy Trial.
Methods
Patients were randomized to wide excision and sentinel node biopsy, or wide excision and nodal observation. We evaluated recurrence site, therapy (selected by treating clinician), and survival after stage IV diagnosis.
Results
Of 291 patients with complete data for stage IV recurrence, 161 (55 %) underwent surgery with or without SMT. Median survival was 15.8 versus 6.9 months, and 4-year survival was 20.8 versus 7.0 % for patients receiving surgery with or without SMT versus SMT alone (
p
< 0.0001; hazard ratio 0.406). Surgery with or without SMT conferred a survival advantage for patients with M1a (median > 60 months vs. 12.4 months; 4-year survival 69.3 % vs. 0;
p
= 0.0106), M1b (median 17.9 vs. 9.1 months; 4-year survival 24.1 vs. 14.3 %;
p
= 0.1143), and M1c (median 15.0 vs. 6.3 months; 4-year survival 10.5 vs. 4.6 %;
p
= 0.0001) disease. Patients with multiple metastases treated surgically had a survival advantage, and number of operations did not reduce survival in the 67 patients (42 %) who had multiple surgeries for distant melanoma.
Conclusions
Our findings suggest that over half of stage IV patients are candidates for resection and exhibit improved survival over patients receiving SMT alone, regardless of site and number of metastases. We have begun a multicenter randomized phase III trial comparing surgery versus SMT as initial treatment for resectable distant melanoma.</abstract><cop>New York</cop><pub>Springer-Verlag</pub><pmid>22648554</pmid><doi>10.1245/s10434-012-2398-z</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1068-9265 |
| ispartof | Annals of surgical oncology, 2012-08, Vol.19 (8), p.2547-2555 |
| issn | 1068-9265 1534-4681 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_3405182 |
| source | MEDLINE; SpringerLink Journals - AutoHoldings |
| subjects | Female Follow-Up Studies Humans Lymph Node Excision - mortality Lymphatic Metastasis Male Medicine Medicine & Public Health Melanoma Melanoma - mortality Melanoma - secondary Melanoma - surgery Metastasectomy - mortality Middle Aged Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Neoplasm Recurrence, Local - surgery Neoplasm Staging Oncology Prognosis Retrospective Studies Skin Neoplasms - mortality Skin Neoplasms - pathology Skin Neoplasms - surgery Surgery Surgical Oncology Survival Rate |
| title | Metastasectomy for Distant Metastatic Melanoma: Analysis of Data from the First Multicenter Selective Lymphadenectomy Trial (MSLT-I) |
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