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Posted by on May 16, 2017 in Melanoma | 0 comments

In a nutshell

This study investigated the survival outcomes of surgery in melanoma patients with metastasis in the abdominal organs (AV; spread to others internal organs such as liver, stomach etc). Researchers suggested that surgery is an important treatment option for these patients. 

Some background

Surgery is an important treatment option for melanoma metastasis and is associated with long-term survival. Prior studies showed that surgery was associated with improved outcomes in patients with AV metastasis.  The most active chemotherapy in these patients has response rates of 15-20% and high toxicity. The more recent immune and targeted therapies (that target certain proteins involved in cancer growth or stimulate the immune system to fight cancer cells) are associated with improved responses and less toxicity. Therefore, the role of surgery in melanoma patients with AV metastasis treated with the immune or targeted therapies is unclear.  

Methods & findings

The objective of this study was to investigate the survival outcomes of surgery in melanoma patients with AV metastasis.

This study included information about 1623 melanoma patients with AV metastasis, including the gastrointestinal tract, liver, adrenal glands, pancreas, and spleen. 305 patients had metastases in multiple sites. Patients were compared based on the era in which they were treated: before recent advances in therapy (up to 2003) or after (2004-2014).

Patients with AV in the gastrointestinal tract had the best overall survival (time from treatment until death from any cause) outcomes, with 1-year survival of 37%. These patients had an average overall survival of 64 months. Patients treated with surgery had a 41% improvement in the odds of a better survival compared to those who did not undergo surgery. Patients with tumor ulceration (shedding of dead cells from the center of the tumor, thought to reflect rapid tumor growth) were 21% more likely to have a worse overall survival.

There was no significant difference in survival between the two treatment eras.

The bottom line

This study suggested that surgery is still an important treatment option even in the era of newer therapies.

Published By :

JAMA surgery

Date :

Apr 05, 2017

Original Title :

Association of Surgical Treatment, Systemic Therapy, and Survival in Patients With Abdominal Visceral Melanoma Metastases, 1965-2014: Relevance of Surgical Cure in the Era of Modern Systemic Therapy.

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