Farooq Mohammad Saad, Mattfeld Valentina, Beniwal Pamela Chopra, Vargas Gracia Maria, Shafique Neha, Miura John T, Karakousis Giorgos C
Division of Endocrine and Oncologic Surgery, Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Ann Surg Oncol. 2025 Sep 4. doi: 10.1245/s10434-025-18263-z.
Interest in evaluating neoadjuvant immunotherapy for stage IIB/IIC melanoma is growing, but studies assessing long-term outcomes generally report data based on pathologic stage after sentinel lymph node microstaging. This study therefore aimed to characterize real-world recurrence patterns and survival specifically in clinical stage IIB/IIC melanoma to contextualize outcomes for selection of patients to undergo neoadjuvant immunotherapy.
This single-institution retrospective cohort study included patients who received a diagnosis of American Joint Committee on Cancer eighth-edition clinical stage IIB/IIC cutaneous melanoma from 2006 to 2019. Factors associated with recurrence were analyzed using univariable analysis and multivariable Cox proportional hazards analysis. Recurrence-free survival (RFS), melanoma-specific survival (MSS), and overall survival (OS) were analyzed using the Kaplan-Meier method.
The inclusion criteria were met by 229 patients, of whom 152 (66%) were male and 208 (91%) were white. The median follow-up time was 64 months (interquartile range [IQR] 29-105 months). Overall, 101 (44%) patients experienced a recurrence, with a median time-to-recurrence of 15.3 months (IQR 8-31 months). The estimated 2-year RFS, MSS, and OS were 69%, 91%, and 87%, respectively. The presence of pre-surgical lymphovascular invasion (hazard ratio [HR] 1.764; p = 0.018) was associated with increased risk of recurrence.
This single-institution retrospective cohort study of patients with clinical stage IIB/IIC melanoma found a 2-year RFS of 69%. The presence of pre-surgical lymphovascular invasion was significantly associated with recurrence in this population. These data can help guide clinicians and researchers in the design and assessment of future studies evaluating neoadjuvant therapy in clinical stage IIB/IIC melanoma and in optimizing patient selection.
评估IIB/IIC期黑色素瘤新辅助免疫疗法的兴趣日益浓厚，但评估长期疗效的研究通常报告基于前哨淋巴结微分期后的病理分期数据。因此，本研究旨在明确临床IIB/IIC期黑色素瘤的真实复发模式和生存率，以便为选择接受新辅助免疫疗法的患者提供背景信息。
这项单机构回顾性队列研究纳入了2006年至2019年被诊断为美国癌症联合委员会第八版临床IIB/IIC期皮肤黑色素瘤的患者。使用单变量分析和多变量Cox比例风险分析来分析与复发相关的因素。采用Kaplan-Meier方法分析无复发生存期（RFS）、黑色素瘤特异性生存期（MSS）和总生存期（OS）。
229名患者符合纳入标准，其中152名（66%）为男性，208名（91%）为白人。中位随访时间为64个月（四分位间距[IQR]29 - 105个月）。总体而言，101名（44%）患者出现复发，中位复发时间为15.3个月（IQR 8 - 31个月）。估计的2年RFS、MSS和OS分别为69%、91%和87%。术前淋巴管侵犯的存在（风险比[HR]1.764；p = 0.018）与复发风险增加相关。
这项针对临床IIB/IIC期黑色素瘤患者的单机构回顾性队列研究发现2年RFS为69%。术前淋巴管侵犯的存在与该人群的复发显著相关。这些数据可帮助指导临床医生和研究人员设计和评估未来评估临床IIB/IIC期黑色素瘤新辅助治疗的研究，并优化患者选择。
