Impact of Effective Systemic Therapy on Metastasectomy in Stage IV Melanoma: A Matched-Pair Analysis

Autor: Mark B. Faries, Ahmed Dehal, Trevan D Fischer, Stacey L. Stern, Daniel W. Nelson, Anton J. Bilchik, Amanda N Graff-Baker
Rok vydání: 2019
Předmět:
Zdroj: Annals of Surgical Oncology. 26:4610-4618
ISSN: 1534-4681
1068-9265
DOI: 10.1245/s10434-019-07487-5
Popis: Although resection historically played a prominent role in the treatment of metastatic melanoma, recent advances have altered the therapeutic landscape, and potentially the role of surgery. We examined surgical selection and metastasectomy outcomes before and after the onset of the effective drug therapy era. Patients with stage IV melanoma were identified and characterized by treatment era (either 1965–2007 or 2008–2015) and by systemic therapy agents. BRAF and/or MEK inhibitors, as well as checkpoint inhibitors, were included as modern agents. Selection factors for metastasectomy were examined by era. A matched-pair analysis of outcomes of surgical and non-surgical patients receiving modern systemic agents was performed. Among 2353 eligible patients, 1065 (45.2%) underwent surgical treatment. Factors associated with selection for metastasectomy in the early era included female sex, no prior stage III disease, single-organ involvement, and M1a (vs. M1c) disease (all p
Databáze: OpenAIRE
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