Prognosis of skin melanoma with regional node metastases (stage II)

Cascinelli, Natale; Vaglini, M.; Nava, Maurizio; Santinami, Mario; Marolda, Raffaele; Rovini, Dario; Clemente, Claudio; Bufalino, Rossaria; Morabito, Alberto

doi:10.1002/jso.2930250404

Cited by 83 publications

(26 citation statements)

References 9 publications

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“…The prognosis of stage Illb melanoma patients is poor (overall 5-year survival: 36%), particularly when mor than one node is histologically involved [9][10][11][12], showing the need for effective adjuvant therapy to improve DFS.…”

Section: Discussionmentioning

confidence: 99%

Adjuvant Therapy of Stage IIIb Melanoma with Interferon Alfa-2b: Clinical and Immunological Relevance

Doveil¹,

Fierro²,

Novelli³

et al. 1995

Dermatology

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Background: The poor prognosis of stage IIIb melanoma (5-year survival: 36%) shows the need for effective adjuvant therapy to prolong disease-free survival. Objective: The feasibility and efficacy of interferon alfa-2b (IFN-α) therapy in stage IIIb melanoma patients was investigated. Methods: alpha-IFN was given at a dose of 3 MU i.m. three times a week to 50 patients. Clinical and immunological controls were carried out. Results: The median follow-up was 43 months (range 5-84). Median survival was 43 months and median disease-free survival 39 months. Overall 5-year survival (62%) was higher than that reported in the literature to date. A significant increase of circulating CD56+ and DR+ lymphocytes after therapy was more evident in disease-free patients than in those with progressing disease. Conclusion: Adjuvant IFN-α therapy in stage IIIb melanoma patients is well tolerated and seems to increase survival. However, multicenter randomized trials are needed to confirm these preliminary findings.

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Section: Discussionmentioning

confidence: 99%

Adjuvant Therapy of Stage IIIb Melanoma with Interferon Alfa-2b: Clinical and Immunological Relevance

Doveil¹,

Fierro²,

Novelli³

et al. 1995

Dermatology

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“…More than half of these patients die of their disease within 2 years (Cascinelli et al, 1984), and the prospects are even worse for patients with distant metastases (AJCC stage IV). Even when surgical excision is feasible, the 2 year survival rates for these patients range only from 14 to 26% (Eton et al, 1998).…”

mentioning

confidence: 99%

Autologous cell vaccine as a post operative adjuvant treatment for high-risk melanoma patients (AJCC stages III and IV)

Lotem¹,

Peretz²,

Drize³

et al. 2002

Br J Cancer

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This study evaluates the overall survival and disease free survival of melanoma patients that were treated with an autologous melanoma cell vaccine, administered as a post-operative adjuvant. Included are 43 patients with totally resected metastatic melanoma (28-AJCC stage III, 15-AJCC stage IV), with a median follow up of 34 months (6 -62). The treatment consisted of eight doses of a vaccine made of 10 -25610 6 autologous melanoma cells either released from the surgical specimen or grown in cell cultures. Tumour cells were conjugated with hapten dinitrophenyl, mixed with Bacille Calmette Guérin and irradiated to 110 Gy. Both disease free survival and overall survival were found to be correlated with intensity of evolving delayed type hypersensitivity to subcutaneous injection of unmodified melanoma cells. Patients with a delayed type hypersensitivity reaction of 510 mm had a median disease free survival of 17 months (mean 35 months) and a mean overall survival of 63 months (median not reached). In contrast, patients with a negative or weak delayed type hypersensitivity had a median disease free survival of 9 months (relative risk of recurrence=4.5, P=0.001), and a median overall survival of 16 months (relative risk of death=15, P=0.001). Stage III patients with a positive delayed type hypersensitivity reaction had an improved disease free survival of 16 months and a mean overall survival of 38 months, whereas patients with a negative delayed type hypersensitivity had a median disease free survival of 7 months (relative risk=4.5, P=0.02) and a median overall survival of 16 months (relative risk=9.5, P=0.005). The adjuvant administration of autologous melanoma vaccine was associated with improved disease-free and overall survival to selected patients who successfully attained anti-melanoma reactivity as detected by positive delayed type hypersensitivity reactions to unmodified melanoma cells.

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“…Bevilacqua et al also found that the percentage of positive nodes was predictive of outcome in patients with melanoma metastatic to axillary nodes [8]. Further, the presence or absence of extranodal soft-tissue disease within the lymphadenectomy specimen has been found highly predictive outcome in melanoma [8,17,18].…”

Section: Biological Argumentsmentioning

confidence: 95%

“…These studies have shown that in patients with melanoma metastatic to regional nodes, tumor burden is a consistent and important predictor of outcome. The number of positive nodes has been shown to be a significant prognostic factor by univariate analysis in several studies [7][8][9][10] and by multivariate analysis in others [11][12][13][14][15][16][17]. Fiveyear survival has been found to decrease steadily as the number of positive lymph nodes increases [7][8][9][10][11][12][13][15][16][17][18].…”

Section: Biological Argumentsmentioning

confidence: 98%