Thursday, October 8, 2015

Surgery for certain melanoma patients doubles survival time

CANCER DIGEST – Oct. 8, 2015 – Patients with melanoma who undergo surgery to remove cancer that has spread into the abdomen live more than twice as long as those treated with drug therapy alone, according a new research study presented to 2015 Clinical Congress of the American College of Surgeons in Chicago this week.

In this study, which updated data tracked over 45 years of 1,623 patients treated at the John Wayne Cancer Institute, overall survival was defined as how long the patient lived after diagnosis of stage 4 melanoma, in which the cancer has spread to parts of the abdomen, including the GI tract, liver, spleen, adrenal glands and other organs.

To determine whether treatment era affected survival, the investigators divided patients into two groups, those treated between 1969 and 2003, and after (2003 to 2014) when advanced immunotherapy began to be used.  The latter group contained 320 patients. 

Nearly one in four patients (392 of 1,623) underwent surgery to remove tumors from various areas of the abdomen. The operations were performed alone, combined with drug therapy, or in some cases, included radiofrequency ablation or heat probe treatment to destroy cancer cells.

When the investigators combined all abdominal locations of melanoma spread, they found that the surgical group's median survival was 18 months compared to only seven months for the nonsurgical group of 1,231 patients.

Contrary to what the researchers expected, treatment in the era of more effective systemic immunotherapy did not significantly affect survival compared to earlier treatment, said Anton J. Bilchik, MD, PhD, the study's senior investigator and a professor of surgery and chief of medicine at the John Wayne Cancer Institute.

Immunotherapies approved for melanoma treatment by the FDA in just the past several years have offered alternatives to standard chemotherapy for metastatic cases where the cancer has spread, which once were considered hopeless. Surgery in metastatic disease, which removes cancerous portions of organs, is seldom performed, but this study may cause clinical researchers to reconsider surgery in tandem with immunotherapy in select groups of patients.

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