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Posted by on Apr 2, 2013 in Melanoma | 0 comments

In a nutshell

This article provides the results of a study investigating surgical removal of metastatic stage IV melanomas. Results showed that surgical removal of metastatic melanomas can provide an increased survival time compared to systemic treatment alone.

Some background

Cutaneous melanoma which spread to other organs of the body (stage IV) is rarely treated with surgery.  This is because other tumours are likely to develop from cancer cells circulating in the blood stream. These patients are generally treated with systemic medical therapy (SMT). SMT can include chemotherapy, biological therapy and immunotherapy.  However, some small studies have shown that surgical removal, especially where tumours can be fully removed, can extend the expected survival. For example, one study showed that patients with stage IV melanoma had a median survival time of 21 months and an estimated 4-year survival of 31% when treated surgically. 

Methods & findings

This study looks at surgical removal of metastatic stage IV melanomas as a potential method for curing the cancer rather than prolonging survival with SMT alone.  This study included 43 patients treated with surgery alone, 85 patients treated with surgery followed by SMT, 33 patients treated with SMT followed by surgery and 130 patients treated with SMT alone.
Results showed that patients treated with surgery alone had the highest median survival time of 22.1 months and the highest 4-year survival rate of 45.7% when compared to the other three treatment groups.  Patients treated with the current method of treatment which is SMT alone had the lowest median survival time of 6.9 months and the lowest 4 year survival rate of 7%.

The bottom line

Overall, the paper suggests that surgical removal of metastatic tumors in patients with stage IV melanoma might be a better option than the current treatment with SMT alone.

What’s next?

Patients may wish to discuss surgical treatment with their consultants, as surgery provided better survival rates than SMT alone no matter if it was carried out before or after SMT. 

Published By :

Annals of Surgical Oncology

Date :

May 31, 2012

Original Title :

Metastasectomy for Distant Metastatic Melanoma: Analysis of Data from the First Multicenter Selective Lymphadenectomy Trial (MSLT-I)

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