The impact of effective systemic therapies on surgery for stage IV melanoma

The outcomes of patients with metastatic melanoma have significantly improved with the introduction of effective systemic therapies (ESTs). The role of surgery in the context of ESTs for stage IV melanoma is evolving. We sought to characterise the changing patterns of surgery and oncological outcome...

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Bibliographic Details
Published in:European journal of cancer (1990) 2018-11, Vol.103, p.24-31
Main Authors: Smith, M.J.F., Smith, H.G., Joshi, K., Gore, M., Strauss, D.C., Hayes, A.J., Larkin, J.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Evolution
Female
Humans
Identification methods
Immune checkpoint inhibitors
Immunotherapy
Immunotherapy - methods
Inhibitor drugs
Intervention
Male
Melanoma
Melanoma - pathology
Melanoma - therapy
Metastasectomy
Metastases
Metastasis
Middle Aged
Neoplasm Staging
Patients
Skin Neoplasms - pathology
Skin Neoplasms - therapy
Stage IV melanoma
Surgery
Survival
Young Adult
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Summary:The outcomes of patients with metastatic melanoma have significantly improved with the introduction of effective systemic therapies (ESTs). The role of surgery in the context of ESTs for stage IV melanoma is evolving. We sought to characterise the changing patterns of surgery and oncological outcomes in patients with stage IV melanoma treated before and after the establishment of ESTs. Patients undergoing surgical resection of stage IV melanoma were identified from our institutional database from 2003 to 2015. Patients were grouped into two cohorts, those referred before EST (2003–2007) and after EST (2011–2015). Clinicopathological variables, patterns of surgery and oncological outcomes in the two groups were compared. A total of 138 patients underwent surgery for stage IV melanoma (n = 69 in each cohort). We observed no significant difference in the ratio of operations/patients performed. However, the pattern of operations altered, with a significant decrease in in-transit excisions (0.9% vs. 19.4%, p 
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2018.08.008