Abstract
Survival of patients with stage IIIC and IIID melanomas with nodal metastases in the light of new therapies
- Department of Oncology, Wroclaw Medical University, Wroclaw, Poland
- Department of Surgical Oncology, Lower Silesian Oncology Pulmonology and Hematology Center, Wroclaw, Poland
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska Curie-National Research Institute of Oncology, Warsaw, Poland
- Laboratory of Immunopathology, Department of Experimental Therapy, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wroclaw, Poland
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, Krakow, Poland
- Department of Surgical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Krakow Branch, Krakow, Poland
- Chair of Surgery, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Kracow University, Krakow, Poland
- Department of General, Oncological and Vascular Surgery, 5th Military Clinical Hospital, Krakow, Poland
- Maria Sklodowska-Curie National Research Institute of Oncology, Scientific Editorial Office, Warsaw, Poland
- Department of Bone Marrow Transplantation and Onco-Hematology, Maria Sklodowska-Curie National Research Institute of Oncology, Gliwice Branch, Gliwice, Poland
- Department of Oncological and Reconstructive Surgery, Maria Sklodowska-Curie National Research Institute of Oncology Gliwice Branch, Gliwice, Poland
Introduction
Within stage III melanoma prognosis and outcomes significantly vary. Advances in systemic therapy improved prognosis in metastatic melanoma. Adjuvant therapy in stage III significantly lowered relapses, although the effect on survival is less evident. Analysis of treatment results in stage IIIC and IIID before introduction of the modern adjuvant therapy, but after introduction of the effective systemic therapy in metastatic relapse, is needed. Aim: To analyse the clinical outcomes in patients with stage IIIC and IIID melanoma before the introduction of the novel adjuvant therapy.
Material and methods
Consecutive stage IIIC and IIID melanoma patients treated in 2015–2018 in 4 reference centres in Poland were enrolled in the analysis of RFS and OS (in-transit metastases excluded). Median follow-up was 26.6 months (1.7–67.2).
Results
There were 224 stage IIIC and 49 stage IIID patients. Recurrence was observed in 170 (62.2%); 102 (45.5%) deaths in stage IIIC and 28 (57.1%) in stage IIID were reported. RFS and OS were better in stage IIIC compared to stage IIID. RFS and OS in the IIIC group were 19.7 and 36.2 months, respectively, and in IIID – 8.9 and 27.8 months, respectively.
Conclusions
The survival of patients with high-risk melanomas has improved in recent years, however, it is still unsatisfactory. The major changes in melanoma management related to the introduction of the adjuvant therapy require further careful observation.
Keywords
stage III melanoma, systemic therapy, adjuvant therapy, immunotherapy, targeted therapy
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