Determination of potential adjuvant systemic therapy benefits for patients with resected cutaneous melanomas.
OBJECTIVE
To facilitate both better physician understanding of prognostic information (baseline and with adjuvant interferon) for individual patients who present with resectable melanomas and more informed patient decisions about whether they should receive adjuvant high-dose interferon therapy after resection of primary melanomas.


METHODS
Baseline survival estimates were derived from a surgical database composed of 17,600 patients with complete clinical, pathologic, and follow-up data. Potential survival benefits ascribed to adjuvant interferon were obtained from results of a meta-analysis of Eastern Cooperative Oncology Group studies, which provided evidence for a uniform relative benefit of high-dose interferon across different baseline risk groups. A mathematical formula was then applied to these data to allow for individual prognostic information.


RESULTS
The 5-year survival benefits in patients who received high-dose interferon after surgery, using the assumptions of the provided prognoses and interferon survival improvements, ranged up to 13%.


CONCLUSIONS
These data should allow for a better understanding of baseline prognosis in individual patients and a better understanding of the potential benefits of adjuvant interferon. They should also help patients make more informed decisions regarding their treatment options.
Thomé
Stephan D
SD
Division of Medical Oncology, Mayo Clinic, Rochester, Minn 55905, USA.
Loprinzi
Charles L
CL
Heldebrant
Michael P
MP
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007372:Interferons / Q000627:therapeutic use*; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States
D000970:Antineoplastic Agents; D007372:Interferons