Division of GI, Tumor & Endocrine Surgery, University of Colorado Medical Center, Aurora, CO, USA.
Immunotherapy. 2012 Jul;4(7):679-86. doi: 10.2217/imt.12.62.
Completion lymph node dissection (CLND) and adjuvant therapy are recommended for node-positive melanoma patients. We sought to analyze our institution's experience with neoadjuvant biochemotherapy in stage III patients.
Clinical information was extracted from a retrospective database on stage III melanoma patients. Eligible patients received two cycles of biochemotherapy prior to their CLND.
There were 153 patients available for analysis. The average tumor depth was 2.5 mm. More than half of all patients presented with sentinel lymph node-positive disease. Surgical complications occurred in 23% of patients. Patients who experienced an adverse event during their neoadjuvant therapy had a worse overall survival when compared with those who did not (p = 0.005).
Our data suggest that aggressive neoadjuvant treatment prior to CLND does not impact surgical complications. Our surgical outcomes are similar to the current literature when adjuvant therapy is used in stage III melanoma. The inability to tolerate neoadjuvant therapy in stage III melanoma is a negative prognostic indicator.
对于淋巴结阳性的黑色素瘤患者，推荐进行完全淋巴结清扫术 (CLND) 和辅助治疗。我们旨在分析本机构在 III 期患者中应用新辅助化疗的经验。
从黑色素瘤 III 期患者的回顾性数据库中提取临床信息。符合条件的患者在 CLND 前接受两个周期的新辅助化疗。
共有 153 例患者可用于分析。平均肿瘤深度为 2.5 毫米。超过一半的患者出现前哨淋巴结阳性疾病。23%的患者发生手术并发症。与未发生新辅助治疗不良事件的患者相比，发生不良事件的患者总生存期更差（p=0.005）。
我们的数据表明，CLND 前进行积极的新辅助治疗不会影响手术并发症。当在 III 期黑色素瘤中使用辅助治疗时，我们的手术结果与当前文献相似。III 期黑色素瘤无法耐受新辅助治疗是一个预后不良的指标。
