In a nutshell
This article investigated the need for restaging in patients with stage IIIB and IIIC melanoma before starting adjuvant therapy (AT; treatment after surgery).
The authors concluded that restaging should be considered for these high-risk patients before starting the AT.
Some background
Melanoma a type of skin cancer that can easily spread to other organs in the body. Stage III melanoma is currently managed by cutting the tumor out. However, recurrence is high in this group.
An alternative is to treat these patients with AT. This involves medical treatment after surgical removal of the tumor. AT has shown to increase the survival of patients. The patients should be restaged using imaging before first starting this AT. This would improve survival and detect metastases (the cancer spreading from its original location to somewhere else in the body). The need for restaging after surgery and before starting AT in patients with stage III B and C melanoma remains under investigation.
Methods & findings
The study involved 120 patients who had their tumor cut out. They all had imaging to rule out metastases before starting adjuvant therapy. They were broken into two groups. Group 1 had stage IIIB (69) and group 2 had stage IIIC (51).
22 (18%) of the 120 patients had early recurrence despite the re-imaging. The average time between resection of the cancer and recurrence was 7.4 weeks. The recurrence did not show any symptoms in 17 (77%) patients. Metastases were noticed in 5 (23%) patients.
8 patients that had a local relapse (cancer that has come back at or near the same place as the original tumor) had the local treatment. The rest of the patients had distant metastases (cancer had spread to distant parts of the body).
The bottom line
The authors concluded that restaging should be considered for high-risk patients with resected melanoma before starting the AT as the rate of recurrence is very high.
The fine print
This study included a limited number of patients. Larger studies are needed.
Published By :
Annals of Surgical Oncology
Date :
Mar 04, 2019
