Survival analysis after resection of metastatic disease followed by peptide vaccines in patients with Stage IV melanoma.
BACKGROUND
Metastatic melanoma carries a poor prognosis, with a median survival of 7-9 months. Surgical resection of metastatic disease has been advocated to improve survival. Immunotherapy after metastasectomy may further improve the outcome for high-risk resected disease.


METHODS
Charts from patients treated on institutional vaccine trials were analyzed. Patients with American Joint Committee on Cancer (AJCC) Stage IV melanoma who underwent surgical resection of metastatic sites followed by treatment on a peptide vaccine trial were eligible for this study. Survival was calculated from the date of enrollment on the clinical trial.


RESULTS
Forty-one patients met inclusion criteria. The median age was 56.5 years, with approximately equal numbers of men and women. The ECOG performance status was 0 in all patients. Approximately 46% of patients underwent resection of visceral metastases before vaccine. The median follow-up was 5.6 years. The median overall survival was 3.8 years.


CONCLUSIONS
In selected patients with AJCC Stage IV melanoma, resection of metastatic disease followed by vaccine therapy can result in long-term survival.
Tagawa
Scott T
ST
Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Cheung
Eric
E
Banta
Warren
W
Gee
Conway
C
Weber
Jeffrey S
JS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019496:Cancer Vaccines / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007167:Immunotherapy; D008197:Lymph Node Excision; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000556:secondary / Q000628:therapy*; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D022223:Vaccines, Subunit / Q000627:therapeutic use*
D019496:Cancer Vaccines; D022223:Vaccines, Subunit