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Blankenstein, S.A.; Aarts, M.J.B.; Berkmortel, F.W.P.J. van den; Boers-Sonderen, M.J.; Eertwegh, A.J.M. van den; Franken, M.G.; ... ; Akkooi, A.C.J. van (2020)

Surgery for unresectable stage IIIC and IV melanoma in the era of new systemic therapy

Article / Letter to editor
Opportunities for surgical treatment in metastatic melanoma patients have re-emerged due to the development of novel systemic therapeutics over the past decade. The aim of this study is to present data on outcomes of surgery in patients with unresectable stage IIIC and IV melanoma, who have previously been treated with immunotherapy or targeted therapy. Data was extracted from the Dutch Melanoma Treatment Registry (DMTR) on 154 patients obtaining disease control to systemic therapy and undergoing subsequent surgery. Disease control was defined as a complete response (CR), which was seen in 3.2% of patients; a partial response (PR), seen in 46.1% of patients; or stable disease (SD), seen in 44.2% of patients. At a median follow-up of 10.0 months (interquartile range 4-22) after surgery, the median overall survival (OS) had not been reached in our cohort and median progression-free survival (PFS) was 9.0 months (95% CI 6.3-11.7). A CR or PR at first follow-up after surgery was...Show moreOpportunities for surgical treatment in metastatic melanoma patients have re-emerged due to the development of novel systemic therapeutics over the past decade. The aim of this study is to present data on outcomes of surgery in patients with unresectable stage IIIC and IV melanoma, who have previously been treated with immunotherapy or targeted therapy. Data was extracted from the Dutch Melanoma Treatment Registry (DMTR) on 154 patients obtaining disease control to systemic therapy and undergoing subsequent surgery. Disease control was defined as a complete response (CR), which was seen in 3.2% of patients; a partial response (PR), seen in 46.1% of patients; or stable disease (SD), seen in 44.2% of patients. At a median follow-up of 10.0 months (interquartile range 4-22) after surgery, the median overall survival (OS) had not been reached in our cohort and median progression-free survival (PFS) was 9.0 months (95% CI 6.3-11.7). A CR or PR at first follow-up after surgery was associated with both a better OS and PFS compared to stable or progressive disease (p < 0.001). We conclude that selected patients can benefit from surgery after achieving disease control with systemic therapy.Show less
metastatic melanoma
surgery
systemic therapy
Dutch Melanoma Treatment Registry
All authors
Blankenstein, S.A.; Aarts, M.J.B.; Berkmortel, F.W.P.J. van den; Boers-Sonderen, M.J.; Eertwegh, A.J.M. van den; Franken, M.G.; Groot, J.W.B. de; Haanen, J.B.A.G.; Hospers, G.A.P.; Kapiteijn, E.; Piersma, D.; Rijn, R.S. van; Suijkerbuijk, K.P.M.; Tije, A.J. ten; Veldt, A.A.M. van der; Vreugdenhil, G.; Wouters, M.W.J.M.; Akkooi, A.C.J. van
Date
2020-05-01
Journal
Cancers
Volume
12
Issue
5
DOI
doi:10.3390/cancers12051176
Link
https://www.mdpi.com/2072-6694/12/5/1176