A phase 2 trial of complete resection for stage IV melanoma: Results of Southwest Oncology Group Clinical Trial S9430

Jeffrey A. Sosman, James Moon, Ralph J. Tuthill, James A Warneke, John T. Vetto, Bruce G. Redman, P. Y. Liu, Joseph M. Unger, Lawrence E. Flaherty, Vernon K. Sondak

Research output: Contribution to journalArticle

78 Citations (Scopus)

Abstract

BACKGROUND: On the basis of retrospective experience at individual centers, it appears that patients with stage IV melanoma who undergo complete resection have a favorable outcome compared with patients with disseminated stage IV disease. The Southwest Oncology Group (SWOG) performed a prospective trial in patients with metastatic melanoma who were enrolled before complete resection of their metastatic disease and provided prospective outcomes in the cooperative group setting. METHODS: Based on their physical examination and radiologic imaging studies, patients with a stage IV melanoma judged amenable to complete resection underwent surgery within 28 days of enrollment. All eligible patients were followed with scans (computed tomography or positron emission tomography) every 6 months until relapse and death. RESULTS: Seventy-seven patients were enrolled from 18 different centers. Of those, 5 patients were ineligible; 2 had stage III disease alone; and 3 had no melanoma in their surgical specimen. In addition, 8 eligible patients had incompletely resected tumor. Therefore, the primary analysis included 64 completely resected patients. Twenty patients (31%) had visceral disease. With a median follow-up of 5 years, the median relapse-free survival was 5 months (95% CI, 3-7 months) whereas median overall survival was 21 months (95% CI, 16-34 months). Overall survivals at 3 and 4 years were 36% and 31%, respectively. CONCLUSIONS: In a prospective multicenter setting, appropriately selected patients with stage IV melanoma achieved prolonged overall survival after complete surgical resection. Although median relapse-free survival was only 5 months, patients could still frequently undergo subsequent surgery for isolated recurrences. This patient population is appropriate for aggressive surgical therapy and for trials evaluating adjuvant therapy. Cancer 2011;. © 2011 American Cancer Society. One of the only prospective analyses of surgery for metastatic disease in patients with stage IV disease, this article reports on a multicenter cooperative group trial with enrollment of patients from 18 different institutions. Incorporating consistent monitoring is a hallmark of cooperative group trials.

Original languageEnglish (US)
Pages (from-to)4740-4746
Number of pages7
JournalCancer
Volume117
Issue number20
DOIs
StatePublished - Oct 15 2011

Fingerprint

Melanoma
Clinical Trials
Survival
Recurrence
Physical Examination
Neoplasms

Keywords

  • clinical trial
  • melanoma
  • prognosis
  • surgery

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Sosman, J. A., Moon, J., Tuthill, R. J., Warneke, J. A., Vetto, J. T., Redman, B. G., ... Sondak, V. K. (2011). A phase 2 trial of complete resection for stage IV melanoma: Results of Southwest Oncology Group Clinical Trial S9430. Cancer, 117(20), 4740-4746. https://doi.org/10.1002/cncr.26111

A phase 2 trial of complete resection for stage IV melanoma : Results of Southwest Oncology Group Clinical Trial S9430. / Sosman, Jeffrey A.; Moon, James; Tuthill, Ralph J.; Warneke, James A; Vetto, John T.; Redman, Bruce G.; Liu, P. Y.; Unger, Joseph M.; Flaherty, Lawrence E.; Sondak, Vernon K.

In: Cancer, Vol. 117, No. 20, 15.10.2011, p. 4740-4746.

Research output: Contribution to journalArticle

Sosman, JA, Moon, J, Tuthill, RJ, Warneke, JA, Vetto, JT, Redman, BG, Liu, PY, Unger, JM, Flaherty, LE & Sondak, VK 2011, 'A phase 2 trial of complete resection for stage IV melanoma: Results of Southwest Oncology Group Clinical Trial S9430', Cancer, vol. 117, no. 20, pp. 4740-4746. https://doi.org/10.1002/cncr.26111
Sosman, Jeffrey A. ; Moon, James ; Tuthill, Ralph J. ; Warneke, James A ; Vetto, John T. ; Redman, Bruce G. ; Liu, P. Y. ; Unger, Joseph M. ; Flaherty, Lawrence E. ; Sondak, Vernon K. / A phase 2 trial of complete resection for stage IV melanoma : Results of Southwest Oncology Group Clinical Trial S9430. In: Cancer. 2011 ; Vol. 117, No. 20. pp. 4740-4746.
@article{2001299b997c46318908c5979352d266,
title = "A phase 2 trial of complete resection for stage IV melanoma: Results of Southwest Oncology Group Clinical Trial S9430",
abstract = "BACKGROUND: On the basis of retrospective experience at individual centers, it appears that patients with stage IV melanoma who undergo complete resection have a favorable outcome compared with patients with disseminated stage IV disease. The Southwest Oncology Group (SWOG) performed a prospective trial in patients with metastatic melanoma who were enrolled before complete resection of their metastatic disease and provided prospective outcomes in the cooperative group setting. METHODS: Based on their physical examination and radiologic imaging studies, patients with a stage IV melanoma judged amenable to complete resection underwent surgery within 28 days of enrollment. All eligible patients were followed with scans (computed tomography or positron emission tomography) every 6 months until relapse and death. RESULTS: Seventy-seven patients were enrolled from 18 different centers. Of those, 5 patients were ineligible; 2 had stage III disease alone; and 3 had no melanoma in their surgical specimen. In addition, 8 eligible patients had incompletely resected tumor. Therefore, the primary analysis included 64 completely resected patients. Twenty patients (31{\%}) had visceral disease. With a median follow-up of 5 years, the median relapse-free survival was 5 months (95{\%} CI, 3-7 months) whereas median overall survival was 21 months (95{\%} CI, 16-34 months). Overall survivals at 3 and 4 years were 36{\%} and 31{\%}, respectively. CONCLUSIONS: In a prospective multicenter setting, appropriately selected patients with stage IV melanoma achieved prolonged overall survival after complete surgical resection. Although median relapse-free survival was only 5 months, patients could still frequently undergo subsequent surgery for isolated recurrences. This patient population is appropriate for aggressive surgical therapy and for trials evaluating adjuvant therapy. Cancer 2011;. {\circledC} 2011 American Cancer Society. One of the only prospective analyses of surgery for metastatic disease in patients with stage IV disease, this article reports on a multicenter cooperative group trial with enrollment of patients from 18 different institutions. Incorporating consistent monitoring is a hallmark of cooperative group trials.",
keywords = "clinical trial, melanoma, prognosis, surgery",
author = "Sosman, {Jeffrey A.} and James Moon and Tuthill, {Ralph J.} and Warneke, {James A} and Vetto, {John T.} and Redman, {Bruce G.} and Liu, {P. Y.} and Unger, {Joseph M.} and Flaherty, {Lawrence E.} and Sondak, {Vernon K.}",
year = "2011",
month = "10",
day = "15",
doi = "10.1002/cncr.26111",
language = "English (US)",
volume = "117",
pages = "4740--4746",
journal = "Cancer",
issn = "0008-543X",
publisher = "John Wiley and Sons Inc.",
number = "20",

}

TY - JOUR

T1 - A phase 2 trial of complete resection for stage IV melanoma

T2 - Results of Southwest Oncology Group Clinical Trial S9430

AU - Sosman, Jeffrey A.

AU - Moon, James

AU - Tuthill, Ralph J.

AU - Warneke, James A

AU - Vetto, John T.

AU - Redman, Bruce G.

AU - Liu, P. Y.

AU - Unger, Joseph M.

AU - Flaherty, Lawrence E.

AU - Sondak, Vernon K.

PY - 2011/10/15

Y1 - 2011/10/15

N2 - BACKGROUND: On the basis of retrospective experience at individual centers, it appears that patients with stage IV melanoma who undergo complete resection have a favorable outcome compared with patients with disseminated stage IV disease. The Southwest Oncology Group (SWOG) performed a prospective trial in patients with metastatic melanoma who were enrolled before complete resection of their metastatic disease and provided prospective outcomes in the cooperative group setting. METHODS: Based on their physical examination and radiologic imaging studies, patients with a stage IV melanoma judged amenable to complete resection underwent surgery within 28 days of enrollment. All eligible patients were followed with scans (computed tomography or positron emission tomography) every 6 months until relapse and death. RESULTS: Seventy-seven patients were enrolled from 18 different centers. Of those, 5 patients were ineligible; 2 had stage III disease alone; and 3 had no melanoma in their surgical specimen. In addition, 8 eligible patients had incompletely resected tumor. Therefore, the primary analysis included 64 completely resected patients. Twenty patients (31%) had visceral disease. With a median follow-up of 5 years, the median relapse-free survival was 5 months (95% CI, 3-7 months) whereas median overall survival was 21 months (95% CI, 16-34 months). Overall survivals at 3 and 4 years were 36% and 31%, respectively. CONCLUSIONS: In a prospective multicenter setting, appropriately selected patients with stage IV melanoma achieved prolonged overall survival after complete surgical resection. Although median relapse-free survival was only 5 months, patients could still frequently undergo subsequent surgery for isolated recurrences. This patient population is appropriate for aggressive surgical therapy and for trials evaluating adjuvant therapy. Cancer 2011;. © 2011 American Cancer Society. One of the only prospective analyses of surgery for metastatic disease in patients with stage IV disease, this article reports on a multicenter cooperative group trial with enrollment of patients from 18 different institutions. Incorporating consistent monitoring is a hallmark of cooperative group trials.

AB - BACKGROUND: On the basis of retrospective experience at individual centers, it appears that patients with stage IV melanoma who undergo complete resection have a favorable outcome compared with patients with disseminated stage IV disease. The Southwest Oncology Group (SWOG) performed a prospective trial in patients with metastatic melanoma who were enrolled before complete resection of their metastatic disease and provided prospective outcomes in the cooperative group setting. METHODS: Based on their physical examination and radiologic imaging studies, patients with a stage IV melanoma judged amenable to complete resection underwent surgery within 28 days of enrollment. All eligible patients were followed with scans (computed tomography or positron emission tomography) every 6 months until relapse and death. RESULTS: Seventy-seven patients were enrolled from 18 different centers. Of those, 5 patients were ineligible; 2 had stage III disease alone; and 3 had no melanoma in their surgical specimen. In addition, 8 eligible patients had incompletely resected tumor. Therefore, the primary analysis included 64 completely resected patients. Twenty patients (31%) had visceral disease. With a median follow-up of 5 years, the median relapse-free survival was 5 months (95% CI, 3-7 months) whereas median overall survival was 21 months (95% CI, 16-34 months). Overall survivals at 3 and 4 years were 36% and 31%, respectively. CONCLUSIONS: In a prospective multicenter setting, appropriately selected patients with stage IV melanoma achieved prolonged overall survival after complete surgical resection. Although median relapse-free survival was only 5 months, patients could still frequently undergo subsequent surgery for isolated recurrences. This patient population is appropriate for aggressive surgical therapy and for trials evaluating adjuvant therapy. Cancer 2011;. © 2011 American Cancer Society. One of the only prospective analyses of surgery for metastatic disease in patients with stage IV disease, this article reports on a multicenter cooperative group trial with enrollment of patients from 18 different institutions. Incorporating consistent monitoring is a hallmark of cooperative group trials.

KW - clinical trial

KW - melanoma

KW - prognosis

KW - surgery

UR - http://www.scopus.com/inward/record.url?scp=80051988510&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80051988510&partnerID=8YFLogxK

U2 - 10.1002/cncr.26111

DO - 10.1002/cncr.26111

M3 - Article

C2 - 21455999

AN - SCOPUS:80051988510

VL - 117

SP - 4740

EP - 4746

JO - Cancer

JF - Cancer

SN - 0008-543X

IS - 20

ER -