Adjuvant high-dose interferon for cutaneous melanoma is most beneficial for patients with early stage III disease

Authors

  • Daniel A. Anaya MD,

    1. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    Search for more papers by this author
  • Yan Xing MD, MS,

    1. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    Search for more papers by this author
  • Lei Feng MS,

    1. Department of Biostatistics and Applied Mathematics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    Search for more papers by this author
  • Xuelin Huang PhD,

    1. Department of Biostatistics and Applied Mathematics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    Search for more papers by this author
  • Luis H. Camacho MD, MPH,

    1. Department of Research, Oncology Consultants, Houston, Texas
    Search for more papers by this author
  • Merrick I. Ross MD,

    1. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    Search for more papers by this author
  • Jeffrey E. Gershenwald MD,

    1. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    Search for more papers by this author
    • Dr. Gershenwald is a member of the Speakers Bureau for Schering-Plough.

  • Jeffrey E. Lee MD,

    1. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    Search for more papers by this author
  • Paul F. Mansfield MD,

    1. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    Search for more papers by this author
  • Janice N. Cormier MD, MPH

    Corresponding author
    1. Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    2. Department of Biostatistics and Applied Mathematics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas
    • Department of Surgical Oncology, Unit 444, The University of Texas M. D. Anderson Cancer Center, 1400 Holcombe Boulevard, PO Box 301402, Houston, TX 77030-1402
    Search for more papers by this author
    • Fax: (713) 792-4689


Abstract

BACKGROUND.

Evidence from randomized trials in the pre-sentinel lymph node biopsy era indicate that adjuvant treatment with high-dose interferon-α (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.

METHODS.

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.

RESULTS.

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.

CONCLUSIONS.

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. Cancer 2008. © 2008 American Cancer Society.

Ancillary