Anaya Daniel A, Xing Yan, Feng Lei, Huang Xuelin, Camacho Luis H, Ross Merrick I, Gershenwald Jeffrey E, Lee Jeffrey E, Mansfield Paul F, Cormier Janice N
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030-1402, USA.
Cancer. 2008 May 1;112(9):2030-7. doi: 10.1002/cncr.23399.
Evidence from randomized trials in the pre-sentinel lymph node biopsy era indicate that adjuvant treatment with high-dose interferon-alpha (IFN) increases recurrence-free survival (RFS) in patients with high-risk melanoma. However, to the authors' knowledge, the role of this treatment in selected patients with early stage III disease has not been well studied.
The clinical and pathologic characteristics of 486 patients undergoing surgical treatment for stage III melanoma were evaluated and the authors compared outcomes for those given adjuvant treatment with IFN with those patients who had surgery alone. A particular focus was on the effect of IFN therapy on RFS and overall survival (OS) among those patients with stage IIIA disease.
The median follow-up for the entire cohort was 5.2 years; the 5-year RFS and OS rates for the entire group were 41% and 53%, respectively. Adjuvant IFN was given to 141 patients (29%). On multivariate analysis, IFN was found to be the only independent predictor for RFS in patients with stage IIIA disease (hazards ratio of 0.4; 95% confidence interval, 0.2-0.9 [P = .02]). IFN was not found to be associated with increased RFS in patients with more advanced lymph node disease (stage IIIB and stage IIIC). IFN appeared to have no effect on OS in any patient with stage III disease.
Adjuvant treatment with IFN improves RFS in melanoma patients with early stage III disease. The results of the current study should help guide management when considering adjuvant treatment for these patients.
在前哨淋巴结活检时代之前的随机试验证据表明，高剂量干扰素-α（IFN）辅助治疗可提高高危黑色素瘤患者的无复发生存期（RFS）。然而，据作者所知，这种治疗在特定的早期III期疾病患者中的作用尚未得到充分研究。
评估了486例接受III期黑色素瘤手术治疗患者的临床和病理特征，并比较了接受IFN辅助治疗的患者与仅接受手术治疗的患者的结局。特别关注IFN治疗对IIIA期疾病患者RFS和总生存期（OS）的影响。
整个队列的中位随访时间为5.2年；整个组的5年RFS率和OS率分别为41%和53%。141例患者（29%）接受了辅助IFN治疗。多变量分析显示，IFN是IIIA期疾病患者RFS的唯一独立预测因素（风险比为0.4；95%置信区间，0.2 - 0.9 [P = 0.02]）。在淋巴结疾病更晚期（IIIB期和IIIC期）的患者中，未发现IFN与RFS增加相关。在任何III期疾病患者中，IFN似乎对OS均无影响。
IFN辅助治疗可改善早期III期黑色素瘤患者的RFS。本研究结果应有助于指导对这些患者进行辅助治疗时的管理决策。
