Surgery for Metastatic Melanoma: an Evolving Concept

Testori, Alessandro; Blankenstein, Stéphanie A.; Akkooi, A.C.J. van

doi:10.1007/s11912-019-0847-6

Cited by 15 publications

(6 citation statements)

References 60 publications

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“…However, there is a long-standing debate regarding the scope of surgery in patients with AM with distant metastasis 26 27. A few retrospective studies recently reported that patients with AM failed to achieve survival benefits from extensive surgery 28–30. Moreover, due to the rarity of AM, its prognostic classification has remained challenging for many years 31.…”

Section: Discussionmentioning

confidence: 99%

Effect of surgical treatment for anorectal melanoma: a propensity score-matched analysis of the Surveillance, Epidemiology, and End Results programme data

et al. 2022

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ObjectiveAnorectal melanoma (AM) is a rare but aggressive tumour with limited information in the existing literature. This study aimed to assess the effect of surgical treatment for AM and predict the prognosis of affected patients.DesignA retrospective cohort study.SettingData of patients diagnosed with AM between 1975 and 2016 in the USA were collected from the Surveillance, Epidemiology, and End Results (SEER) database.ParticipantsThis study enrolled a total of 795 patients with AM from the SEER database and the validation cohort comprised 40 patients with AM enrolled from Chinese institutes.Primary and secondary outcome measuresOverall survival (OS) and AM-specific survival (AM-SS).ResultsA total of 795 patients with AM diagnosed between 1975 and 2016 were enrolled in this study. Data over the past four decades showed a trend of increase in incidence rate. A nomogram based on a multivariate Cox regression model was generated to predict AM-SS. The C-index of the nomogram was 0.74 (95% CI 0.71 to 0.77) on internal verification. In the validation cohort, the C-index of the nomogram was 0.72 (95% CI 0.68 to 0.76). The results of propensity score matching (PSM) analysis showed that patients who underwent surgical treatment achieved significant survival (OS: log-rank=17.41, p<0.001; AM-SS: log-rank=14.55, p<0.001). Patients who underwent surgery were stratified into local and extended surgery subgroups. AM-SS and OS were also compared after PSM, but the results were not significantly different between the two surgery subgroups (all p>0.05).ConclusionsThe nomogram based on the analysis of SEER data showed good performance in predicting OS and AM-SS. Patients with AM can benefit from surgery; however, extensive surgery and appendectomy may not improve AM-SS or OS.

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Section: Discussionmentioning

confidence: 99%

Effect of surgical treatment for anorectal melanoma: a propensity score-matched analysis of the Surveillance, Epidemiology, and End Results programme data

et al. 2022

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“…Electrochemotherapy is a relatively novel and cost-efficient method of treatment of metastases in patients with advanced cutaneous melanoma [ 13 , 14 ]. Since 2006, when the ESOPE established standardized details of the ECT procedure [ 10 ], the increasing popularity of the use of this method has been observed in cases of lack of response to treatment with other methods and in non-resectable lesions from MM [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

An analysis of clinical effectiveness of electrochemotherapy in the treatment of advanced metastatic malignant melanoma performed in the eastern part of Central Europe: a single-centre experience

Ziętek¹,

Nowacki²,

Wierzbicki³

et al. 2022

pdia

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Introduction: Patients with cutaneous malignant melanoma (MM), in case of non-resectability of the lesions, have only a limited pool of the available treatment options. In recent years especially electrochemotherapy (ECT) has become an increasingly important therapy in locoregionally advanced MM. Aim: In this study an analysis of the ECT treatment of locoregionally advanced malignant melanoma was presented. Material and methods: Six ECT cycles in 5 patients were performed in the Wroclaw Comprehensive Cancer Centre. Treatment response, long-term observation, technical data downloaded from electroporator and photographs taken before and after the ECT were assessed in the analysis. Results: In total, 200 nodules in 5 patients were treated with ECT in palliative intent. After 5 out of 6 ECT cycles, the particular clinical response has been observed. Four patients with primary unresectable lesions underwent 11 surgeries of the cutaneous metastases. In long-term follow-up in 2 patients, of whom one died 19 months after the ECT, the disease progressed and in another two, no recurrence was observed. Conclusions: ECT is an encouraging therapy for patients in whom the recurrent cutaneous melanoma cannot be treated with other methods, however, access to this method in eastern part of Central Europe is limited. The presented study seems to confirm the usefulness of this palliative approach in a specific group of patients suffering from cutaneous MM.

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“…Regardless of how many new drugs are developed, complete surgical resection of the primary lesion has remained the standard initial therapy for melanoma. 7 With regard to locoregional lymph nodes, clinicians have adopted management based on the sentinel node concept. 8 Although MSLT-I showed no significant survival benefit with the use of sentinel navigation surgery, SLNB was proven to be an important procedure that provides prognostic information.…”

Section: Discussionmentioning

confidence: 99%

Observation policy for sentinel node metastasis of melanoma: Comparative study with completion lymph node dissection in Japanese patients

Matsui

Sasaki

Takatsuka

et al. 2021

The Journal of Dermatology

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In recent years, the development of targeted therapy and immunotherapy has drastically changed the treatment landscape for metastatic melanoma. 1 However, surgical resection has remained the standard of care for melanoma, and most cases can be cured via appropriate surgery in the early stage. Despite emphasis of the importance of surgical control for regional lymph nodes in addition to primary tumor removal, the clinical benefit of sentinel node navigation surgery remains debatable. The Multicenter Selective Lymphadenectomy Trial (MSLT)-I, an international randomized trial, compared patients undergoing sentinel lymph node (SLN) biopsy with observation. 2 Although the results demonstrated that SLN status was a significant prognostic factor for melanoma survival, it provided no survival benefit with sentinel node navigation surgery in the overall study population. Since that study was published, two notable randomized controlled trials have been

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Surgery for Metastatic Melanoma: an Evolving Concept

Cited by 15 publications

References 60 publications

Effect of surgical treatment for anorectal melanoma: a propensity score-matched analysis of the Surveillance, Epidemiology, and End Results programme data

Effect of surgical treatment for anorectal melanoma: a propensity score-matched analysis of the Surveillance, Epidemiology, and End Results programme data

An analysis of clinical effectiveness of electrochemotherapy in the treatment of advanced metastatic malignant melanoma performed in the eastern part of Central Europe: a single-centre experience

Observation policy for sentinel node metastasis of melanoma: Comparative study with completion lymph node dissection in Japanese patients

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