[Adjuvant chemotherapy of malignant melanoma with DTIC. Lack of effect in stage I. Possible improvement of the prognosis for survival in stage IIb].

Out of more than 600 melanoma patients on whom records have been kept in the clinical registry of our department since 1969, 153 were treated by adjuvant chemotherapy with dacarbazine from 1977 to 1984. In 50 patients treatment was discontinued after 1-3 cycles of chemotherapy; all of the others underwent 4 or more cycles. From the latter group (n = 103) patients with the primary tumour alone (stage I) or with macroscopic nodal involvement of one region (stage IIb) were selected for evaluation. In stage I the overall survival rates were significantly better in 143 untreated controls than in 72 patients treated with dacarbazine; no significant differences were found for disease-free intervals. In the treated group the major prognostic factors were more significant (tumour thickness, localization, sex). Statistical analysis of 26 matched pairs corresponding in respect to tumour thickness, sex and anatomical site of the primary tumour revealed no significant differences in survival rates or disease-free intervals. Also, no difference was found when 23 patients with thick tumours (greater than or equal to 3 mm) adjuvantly treated with dacarbazine were compared with an untreated control group of 48 patients. In stage IIb 26 patients were treated and were compared with 64 untreated controls; they seemed to benefit from DTIC chemotherapy, showing a 5-year survival rate of 40% versus 18% for the untreated control group (P = 0.028).