التفاصيل البيبلوغرافية
| العنوان: |
The Role of Metastasectomies and Immunotherapy in the Management of Melanoma Lung Metastases: An Analysis of the National Cancer Database. |
| المؤلفون: |
Tasoudis, Panagiotis1 (AUTHOR) shannon_parness@med.unc.edu, Manaki, Vasiliki2 (AUTHOR) vassiamanaki@gmail.com, Parness, Shannon1 (AUTHOR) audrey.khoury@unchealth.unc.edu, Khoury, Audrey L.1 (AUTHOR) benjamin_haithcock@med.unc.edu, Agala, Chris B.3 (AUTHOR) chris_agala@med.unc.edu, Haithcock, Benjamin E.1 (AUTHOR) gita_mody@med.unc.edu, Mody, Gita N.1 (AUTHOR) jason_long@med.unc.edu, Long, Jason M.1 (AUTHOR) |
| المصدر: |
Cancers. Jan2025, Vol. 17 Issue 2, p206. 12p. |
| مصطلحات موضوعية: |
*DATABASES, *MEDICAL information storage & retrieval systems, *IMMUNOTHERAPY, *DISEASE management, *FISHER exact test, *TREATMENT effectiveness, *RETROSPECTIVE studies, *DESCRIPTIVE statistics, *CHI-squared test, *METASTASECTOMY, *KAPLAN-Meier estimator, *LUNG tumors, *MEDICAL records, *ACQUISITION of data, *CONFIDENCE intervals, *PROPORTIONAL hazards models, *OVERALL survival, MORTALITY risk factors |
| مستخلص: |
Simple Summary: Metastatic melanoma classically settles in the lung and these patients tend to have poor outcomes. The surgical removal of the lung metastases, termed a metastasectomy, is a well-known treatment option for select patients with this diagnosis. With the introduction of immunotherapy as a treatment option, the aim of this study was to analyze patient survival based on treatment with a metastasectomy or immunotherapy. Using the National Cancer Database, 625 patients were identified as fitting the criteria of this study. We found that during a median follow-up time of 34.6 months, treatment with a metastasectomy significantly improved survival compared to immunotherapy alone. There was no significant difference between treatment with a metastasectomy alone and a combination of a metastasectomy and immunotherapy. Therefore, our findings contribute to the support for surgical treatment in patients with metastatic melanoma to the lungs. Introduction: Patients with metastatic melanoma to the lung typically have poor outcomes. Although a pulmonary metastasectomy for selected patients has been shown to improve survival, the role of surgical resection following the introduction of immunotherapy for metastatic melanoma is unknown. The objective of this study was to determine predictors of survival for patients with melanoma metastatic to the lung in the era of immunotherapy. Methods: In this retrospective study, data from the National Cancer Database were abstracted for patients with melanoma lung metastases. The overall survival was evaluated using Kaplan–Meier and Cox proportional hazard analysis, adjusting for previously described risk factors for mortality. Patients with concomitant metastases to organs other than the lung were excluded from the study. Results: A total of 625 patients with lung metastases at the time of a skin melanoma diagnosis were identified. A total of 280 patients underwent a pulmonary metastasectomy, 267 received immunotherapy, and 78 were treated with both a metastasectomy and immunotherapy. During a median follow-up time of 34.6 months [IQR: 14.2, 75.9], a metastasectomy was found to offer significantly improved survival compared to immunotherapy alone. No difference was noted between a metastasectomy and a combination of a metastasectomy and immunotherapy in the adjusted Cox proportional hazard model. Conclusions: When statistical models were adjusted for risk factors, a metastasectomy maintained a significant survival advantage compared to immunotherapy. The addition of immunotherapy to the treatment of patients treated with a pulmonary metastasectomy did not improve survival. Our findings support the role of surgery for patients with pulmonary metastatic melanoma. [ABSTRACT FROM AUTHOR] |
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