A neoadjuvant biochemotherapy approach to stage III melanoma: analysis of surgical outcomes. (July 2012)

• Record Type: Journal Article
• Authors: Kounalakis, Nicole; Gao, Dexiang; Gonzalez, Rene; Becker, Maude; Lewis, Karl; Poust, Jamie; Pearlman, Nathan; Robinson, William; McCarter, Martin
• Is Part Of: Immunotherapy. Volume 4:Number 7(2012:Jul.)
• Page Start: 679
• Page End: 686
• Publication Date: 2012-07
• Subjects: biochemotherapy -- completion lymph node dissection -- melanoma -- neoadjuvant therapy -- surgical outcomes; Immunotherapy -- Periodicals; 615.37
• DOI: 10.2217/imt.12.62
• Languages: English
• ISSNs: 1750-743X

Abstract

Aims: Completion lymph node dissection (CLND) and adjuvant therapy are recommended for node-positive melanoma patients. We sought to analyze our institution's experience with neoadjuvant biochemotherapy in stage III patients.Methods: Clinical information was extracted from a retrospective database on stage III melanoma patients. Eligible patients received two cycles of biochemotherapy prior to their CLND.Results: There were 153 patients available for analysis. The average tumor depth was 2.5 mm. More than half of all patients presented with sentinel lymph node-positive disease. Surgical complications occurred in 23% of patients. Patients who experienced an adverse event during their neoadjuvant therapy had a worse overall survival when compared with those who did not (p = 0.005).Conclusion: Our data suggest that aggressive neoadjuvant treatment prior to CLND does not impact surgical complications. Our surgical outcomes are similar to the current literature when adjuvant therapy is used in stage III melanoma. The inability to tolerate neoadjuvant therapy in stage III melanoma is a negative prognostic indicator.