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Results of Southwest Oncology Group Clinical Trial S9430
Article first published online: 31 MAR 2011
Copyright © 2011 American Cancer Society
Volume 117, Issue 20, pages 4740–4706, 15 October 2011
How to Cite
Sosman, J. A., Moon, J., Tuthill, R. J., Warneke, J. A., Vetto, J. T., Redman, B. G., Liu, P. Y., Unger, J. M., Flaherty, L. E. and Sondak, V. K. (2011), A phase 2 trial of complete resection for stage IV melanoma. Cancer, 117: 4740–4706. doi: 10.1002/cncr.26111
Results were presented, in part, at the 42nd Annual Meeting of the American Society of Clinical Oncology, June 2-6, 2006, Atlanta, Georgia.
See editorial on pages 4579-81, this issue.
- Issue published online: 5 OCT 2011
- Article first published online: 31 MAR 2011
- Manuscript Accepted: 17 SEP 2010
- Manuscript Revised: 16 SEP 2010
- Manuscript Received: 7 JUL 2010
- clinical trial
On the basis of retrospective experience at individual centers, it appears that patients with stage IV melanoma who undergo complete resection have a favorable outcome compared with patients with disseminated stage IV disease. The Southwest Oncology Group (SWOG) performed a prospective trial in patients with metastatic melanoma who were enrolled before complete resection of their metastatic disease and provided prospective outcomes in the cooperative group setting.
Based on their physical examination and radiologic imaging studies, patients with a stage IV melanoma judged amenable to complete resection underwent surgery within 28 days of enrollment. All eligible patients were followed with scans (computed tomography or positron emission tomography) every 6 months until relapse and death.
Seventy-seven patients were enrolled from 18 different centers. Of those, 5 patients were ineligible; 2 had stage III disease alone; and 3 had no melanoma in their surgical specimen. In addition, 8 eligible patients had incompletely resected tumor. Therefore, the primary analysis included 64 completely resected patients. Twenty patients (31%) had visceral disease. With a median follow-up of 5 years, the median relapse-free survival was 5 months (95% CI, 3-7 months) whereas median overall survival was 21 months (95% CI, 16-34 months). Overall survivals at 3 and 4 years were 36% and 31%, respectively.
In a prospective multicenter setting, appropriately selected patients with stage IV melanoma achieved prolonged overall survival after complete surgical resection. Although median relapse-free survival was only 5 months, patients could still frequently undergo subsequent surgery for isolated recurrences. This patient population is appropriate for aggressive surgical therapy and for trials evaluating adjuvant therapy. Cancer 2011;. © 2011 American Cancer Society.