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Metastasectomy for melanoma is associated with improved overall survival in responders to targeted molecular or immunotherapy
Author(s) -
Medina Benjamin D.,
Choi Beatrix Hyemin,
Rodogiannis Kathy G.,
Moran Una,
Shapiro Richard L.,
Pavlick Anna,
Osman Iman,
Berman Russell S.,
Lee Ann Y.
Publication year - 2020
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25987
Subject(s) - metastasectomy , medicine , melanoma , cohort , immunotherapy , oncology , retrospective cohort study , targeted therapy , surgery , metastasis , cancer , cancer research
Background and Objectives Metastasectomy for melanoma provides durable disease control in carefully selected patients. Similarly, BRAF‐targeted and immune checkpoint inhibition has improved median overall survival (OS) in metastatic patients. We hypothesized that there is an increasing role for metastasectomy in melanoma patients responding to these therapies. Methods Retrospective analysis of a prospectively maintained database identified 128 patients with stage IV melanoma who received targeted molecular and/or checkpoint inhibitors at an academic institution from 2006 to 2017. Records were reviewed to characterize clinicopathologic characteristics, response to treatment, and intent of surgery for those who underwent metastasectomy. OS was analyzed by the Kaplan‐Meier method. Results Median OS from stage IV diagnosis was 31.3 months. A total of 81 patients received checkpoint inhibitors, 11 received targeted inhibitors, and 36 received both. A total of 73 patients underwent metastasectomy. Indications for surgery included the intent to render disease‐free (54%), palliation (34%), and diagnostic confirmation (11%). Responders to systemic therapy who underwent metastasectomy had improved OS compared to responders who did not (84.3 vs. 42.9 months, P = .018). Conclusions Metastasectomy for melanoma is associated with improved OS in patients that respond to targeted molecular or immunotherapy. Resection should be strongly considered in this cohort as multimodality treatment results in excellent OS.