Blankenstein Stephanie A, Aarts Maureen J B, van den Berkmortel Franchette W P J, Boers-Sonderen Marye J, van den Eertwegh Alfons J M, Franken Margreet G, de Groot Jan Willem B, Haanen John B A G, Hospers Geke A P, Kapiteijn Ellen, Piersma Djura, van Rijn Rozemarijn S, Suijkerbuijk Karijn P M, Ten Tije Albert J, van der Veldt Astrid A M, Vreugdenhil Gerard, Wouters Michel W J M, van Akkooi Alexander C J
Department of Surgical Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX Amsterdam, The Netherlands.
Department of Medical Oncology, Maastricht University Medical Centre, P. Debyelaan 25, 6229 HX Maastricht, The Netherlands.
Cancers (Basel). 2020 May 7;12(5):1176. doi: 10.3390/cancers12051176.
Opportunities for surgical treatment in metastatic melanoma patients have re-emerged due to the development of novel systemic therapeutics over the past decade. The aim of this study is to present data on outcomes of surgery in patients with unresectable stage IIIC and IV melanoma, who have previously been treated with immunotherapy or targeted therapy. Data was extracted from the Dutch Melanoma Treatment Registry (DMTR) on 154 patients obtaining disease control to systemic therapy and undergoing subsequent surgery. Disease control was defined as a complete response (CR), which was seen in 3.2% of patients; a partial response (PR), seen in 46.1% of patients; or stable disease (SD), seen in 44.2% of patients. At a median follow-up of 10.0 months (interquartile range 4-22) after surgery, the median overall survival (OS) had not been reached in our cohort and median progression-free survival (PFS) was 9.0 months (95% CI 6.3-11.7). A CR or PR at first follow-up after surgery was associated with both a better OS and PFS compared to stable or progressive disease ( < 0.001). We conclude that selected patients can benefit from surgery after achieving disease control with systemic therapy.
由于过去十年中新型全身治疗方法的发展，转移性黑色素瘤患者的手术治疗机会再次出现。本研究的目的是提供关于不可切除的IIIC期和IV期黑色素瘤患者手术结果的数据，这些患者先前已接受过免疫治疗或靶向治疗。从荷兰黑色素瘤治疗登记处（DMTR）提取了154例获得全身治疗疾病控制并随后接受手术的患者的数据。疾病控制定义为完全缓解（CR），见于3.2%的患者；部分缓解（PR），见于46.1%的患者；或疾病稳定（SD），见于44.2%的患者。术后中位随访10.0个月（四分位间距4-22），我们队列中的中位总生存期（OS）尚未达到，中位无进展生存期（PFS）为9.0个月（95%CI 6.3-11.7）。与疾病稳定或进展相比，术后首次随访时的CR或PR与更好的OS和PFS均相关（<0.001）。我们得出结论，部分患者在通过全身治疗实现疾病控制后可从手术中获益。
