title: A neoadjuvant biochemotherapy approach to stage III melanoma: analysis of surgical outcomes.
abstract: OBJECTIVE
  Completion lymph node dissection (CLND) and adjuvant therapy are recommended for node-positive melanoma patients. We sought to analyze our institution's experience with neoadjuvant biochemotherapy in stage III patients.
  
  
  METHODS
  Clinical information was extracted from a retrospective database on stage III melanoma patients. Eligible patients received two cycles of biochemotherapy prior to their CLND.
  
  
  RESULTS
  There were 153 patients available for analysis. The average tumor depth was 2.5 mm. More than half of all patients presented with sentinel lymph node-positive disease. Surgical complications occurred in 23% of patients. Patients who experienced an adverse event during their neoadjuvant therapy had a worse overall survival when compared with those who did not (p = 0.005).
  
  
  CONCLUSIONS
  Our data suggest that aggressive neoadjuvant treatment prior to CLND does not impact surgical complications. Our surgical outcomes are similar to the current literature when adjuvant therapy is used in stage III melanoma. The inability to tolerate neoadjuvant therapy in stage III melanoma is a negative prognostic indicator.
authors.affiliation: Division of GI, Tumor & Endocrine Surgery, University of Colorado Medical Center, Aurora, CO, USA. nicole.kounalakis@ucdenver.edu
authors.forename: Nicole
authors.initials: N
authors.lastname: Kounalakis
authors.forename: Dexiang
authors.initials: D
authors.lastname: Gao
authors.forename: Rene
authors.initials: R
authors.lastname: Gonzalez
authors.forename: Maude
authors.initials: M
authors.lastname: Becker
authors.forename: Karl
authors.initials: K
authors.lastname: Lewis
authors.forename: Jamie
authors.initials: J
authors.lastname: Poust
authors.forename: Nathan
authors.initials: N
authors.lastname: Pearlman
authors.forename: William
authors.initials: W
authors.lastname: Robinson
authors.forename: Martin
authors.initials: M
authors.lastname: McCarter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001691:Biological Therapy / Q000009:adverse effects; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D003606:Dacarbazine / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006402:Hematologic Diseases / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects; D007376:Interleukin-2 / Q000008:administration & dosage / Q000009:adverse effects; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods*; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome; D014747:Vinblastine / Q000008:administration & dosage / Q000009:adverse effects; D055815:Young Adult
chemical_list: D016898:Interferon-alpha; D007376:Interleukin-2; D014747:Vinblastine; D003606:Dacarbazine; D002945:Cisplatin