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04.03.2019 | Melanoma | Ausgabe 12/2019 Open Access

Annals of Surgical Oncology 12/2019

Early Recurrence in Completely Resected IIIB and IIIC Melanoma Warrants Restaging Prior to Adjuvant Therapy

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 12/2019
Autoren:
MD Martine Bloemendal, MD Wouter W. van Willigen, MD, PhD Kalijn F. Bol, MD, PhD Marye J. Boers-Sonderen, MD, PhD Johannes J. Bonenkamp, MD J. E. M. Werner, MD, PhD Erik H. J. G. Aarntzen, MD, PhD Rutger H. T. Koornstra, MD, PhD Jan Willem B. de Groot, PhD I. Jolanda M. de Vries, MD, PhD Jacobus J. M. van der Hoeven, MD, PhD Winald R. Gerritsen, MD, PhD Johannes H. W. de Wilt
Wichtige Hinweise
Wouter W. van Willigen and Kalijn F. Bol have contributed equally to this work.

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Abstract

Purpose

To evaluate the results of restaging completely resected stage IIIB/C melanoma prior to start of adjuvant therapy.

Patients and Methods

One hundred twenty patients with stage IIIB or IIIC (AJCC 2009) melanoma who underwent complete surgical resection were screened for inclusion in our trial investigating adjuvant dendritic cell therapy (NCT02993315). All patients underwent imaging to exclude local relapse or metastasis before entering the trial. The frequency of recurrent disease within 12 weeks after resection and the method of detection were investigated.

Results

Sixty-nine (58%) stage IIIB and 51 (43%) stage IIIC melanoma patients were screened. Median age was 54 (range 27–79) years. Twenty-two (18%) of 120 patients with completely resected stage IIIB/C melanoma had evidence of early recurrent disease, despite exclusion thereof by prior imaging. Median interval between resection and detection of relapse was 7.4 (range 4.3–10.7) weeks. Recurrence was asymptomatic in 17 (77%) patients, but metastasis was noticed by the patient or physician in 5 (23%). Eight patients with local relapse received local treatment with curative intent, and one was treated with systemic therapy. The remaining patients had distant metastasis, 1 of whom underwent resection of a solitary liver metastasis while 12 patients received systemic treatment.

Conclusions

Patients with completely resected stage IIIB/C melanoma have high risk of early recurrence before start of adjuvant therapy. Restaging should be considered for high-risk melanoma patients before start of adjuvant therapy.

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