Background: Randomized comparisons have demonstrated survival benefit of adjuvant immunotherapy in node-positive melanoma patients but have limited power to determine if this benefit persists across various demographic factors.
Materials & Methods: We assessed the impact of demographic factors on the survival benefit of adjuvant immunotherapy in a database of 38,189 node-positive melanoma patients using the Kaplan-Meier method and Cox proportional hazards models.
Results: All assessed demographic factors other than race significantly impacted survival of node-positive melanoma patients in univariate analysis. In multivariable analysis, only the age group interacted with immunotherapy.
Conclusion: Analysis of this large database of unselected node-positive melanoma patients demonstrated a positive survival benefit of immunotherapy across all demographic factors assessed and the impact was greater for patients 65 years of age and older.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426750 | PMC |
http://dx.doi.org/10.2217/mmt-2020-0002 | DOI Listing |
J Surg Oncol
January 2025
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Background And Objectives: Since the publication of the German Cooperative Oncology Group Selective Lymphadenectomy Trial and Multicenter Selective Lymphadenectomy Trial II (MSLT2) trials, the treatment paradigm for node-positive melanoma has shifted from completion lymph node dissection (LND) to nodal ultrasound surveillance. We sought to identify the impact of this practice change on postoperative outcomes in a national cohort.
Methods: The American College of Surgeons National Surgical Quality Improvement Program database was queried for patients diagnosed with truncal/extremity malignant melanoma who underwent axillary/inguinal LND.
Am J Surg
December 2024
Western Michigan Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI, 49008, USA. Electronic address:
Background: Cutaneous malignant melanoma has traditionally been a surgically managed disease. Recent clinical trials highlight major shifts in surgical management of this disease, emphasizing a multidisciplinary approach.
Methods: Clinical trials evaluating the role of completion lymph node dissection (CLND) in the management of sentinel lymph node positive patients and more recent trials evaluating the impact of neoadjuvant immunotherapy on patients presenting with clinically advanced but surgically resectable melanoma are reviewed, as well as ongoing trial evaluating surgical margins.
Ann Surg Oncol
November 2024
Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.
Background: Nodal surveillance (NS) has overtaken completion lymphadenectomy as the preferred management for sentinel node-positive (SLN+) melanoma, but requires frequent exams and nodal ultrasound (US). Social determinants of health (SDoH) may affect US adherence in real-world populations, and evaluation of these potential impacts is needed.
Methods: Adults with SLN+ melanoma diagnosed from July 2017 to December 2019 who received NS at nine cancer centers were identified retrospectively.
Am J Surg
January 2025
Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA; Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Veterans Affairs, Birmingham VA Medical Center, Birmingham, AL, USA.
Purpose: The nodal burden of patients with residual isolated tumor cells (ITCs) in the sentinel lymph nodes (SLNs) after neoadjuvant chemotherapy (NAC) (ypN0i+) is unknown, and axillary management is not standardized. We investigated rates of additional positive lymph nodes (LNs) at axillary lymph node dissection (ALND) and oncologic outcomes in patients with ypN0i+ treated with and without ALND.
Methods: The Oncoplastic Breast Consortium-05/ICARO cohort study (ClinicalTrials.
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